Growth context
BLS projects occupational therapist employment to grow 14% from 2024 to 2034. Occupational therapy assistants are projected at 19% growth over the same period.
Career rankings
OT salary rankings need tradeoffs, not just numbers.
The OT Index uses BLS wage tables by setting and adds the practical signals clinicians need: autonomy, documentation burden, schedule quality, and career upside.
OT settingsOTA settingsSalaryGrowthNegotiation
Occupational therapists
Highest-paying major OT settings
BLS OOH publishes median annual wages for the top industries employing occupational therapists. The OT Index ranks the settings and translates the tradeoff.
| Rank | Setting | Median annual wage | Why it matters | The OT Index signal |
|---|---|---|---|---|
| 1 | Nursing care facilities | $103,210 | Skilled nursing facilities lead the major published OT settings in the BLS OOH wage table. | High pay, productivity scrutiny, heavier documentation |
| 2 | Home healthcare services | $103,010 | Nearly tied with SNF pay and central to aging-in-place demand. | High autonomy, travel time, variable caseload density |
| 3 | Hospitals | $100,770 | Strong pay with acute-care skill development and interdisciplinary exposure. | Broad experience, weekend rotations, faster pace |
| 4 | Therapy offices | $96,380 | Includes offices of physical, occupational, and speech therapists, and audiologists. | Outpatient depth, productivity metrics, specialty upside |
| 5 | Educational services | $83,890 | Lower median pay but attractive calendars and high pediatric demand. | Schedule quality, IEP load, district variability |
Occupational therapy assistants
Highest-paying major OTA settings
OTA pay deserves its own ranking because the degree path, salary ceiling, and employer mix differ from the occupational therapist market.
| Rank | Setting | Median annual wage | Why it matters | The OT Index signal |
|---|---|---|---|---|
| 1 | Home healthcare services | $76,800 | Highest published median among major OTA settings in the BLS OOH table. | High pay, mobility, independence |
| 2 | Nursing care facilities | $75,860 | Close second and one of the largest OTA practice settings. | Volume, productivity, clinical reps |
| 3 | Therapy offices | $65,590 | Core outpatient and clinic employment category. | Stable setting, local market dependent |
| 4 | Hospitals | $65,280 | Similar pay to therapy offices with broader care-team exposure. | Training depth, shift mix |
| 5 | Educational services | $59,240 | Often lower pay, but school schedules can offset the wage gap for some clinicians. | Pediatrics, calendar flexibility, caseload complexity |
City comparisons
Metro rankings compare wage, job density, cost pressure, home-health availability, school pipeline, and licensure friction.
Negotiation angle
Setting-level rankings become salary negotiation pages when paired with state/metro wage data and anonymous clinician compensation reports.
Career sources
Career rankings start with BLS
BLS provides the national career context. State tables, metro tables, job postings, and verified salary reports add more local detail.