What is the real hourly value?
Annual salary can hide unpaid documentation, commute time, visit gaps, cancellations, and weekend expectations.
OT salary guide
Occupational therapy salary only makes sense with the tradeoffs attached.
Compare OT and OTA pay by setting, state, and city, then read the wage beside job depth, documentation burden, schedule quality, commute reality, and employer fit.
OT salaryOTA salarySettingsStatesCities
Salary framework
Start with the number, then ask what it costs to earn it.
The best-paid role is not always the best job. A salary offer has to be read beside productivity, documentation, benefits, mileage, mentorship, census stability, and the local market.
Which setting creates the pay?
Skilled nursing, home health, hospitals, schools, outpatient clinics, and pediatrics can produce different wages for different reasons.
How strong is the local market?
A high state wage is more useful when it comes with enough local jobs, employer choice, and manageable cost of living.
By setting
Highest-paying major OT settings
Setting-level pay is the cleanest starting point because it connects directly to schedule, documentation, productivity model, autonomy, and day-to-day workload.
| 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 |
Geography
Salary changes when the market changes.
A state or city with higher wages may also have higher living costs, fewer openings, heavier competition, or a setting mix that does not match the work you want.
Top state salary markets
Top city salary markets
Boston-Cambridge-Newton, MA-NH: $100,730 mean wageNew York-Newark-Jersey City, NY-NJ: $107,110 mean wageLittle Rock-North Little Rock-Conway, AR: $103,360 mean wageSan Antonio-New Braunfels, TX: $111,140 mean wageWaterbury-Shelton, CT: $102,190 mean wageSan Francisco-Oakland-Fremont, CA: $136,250 mean wage
Assistant pay
OTA salary needs a separate read.
Occupational therapy assistant pay should not be inferred from OT pay. The degree path, supervision model, setting mix, and advancement ceiling are different.
| 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 |
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