Decision framework
What to know before you compare options
Built from BLS wage tables, The OT Index setting model, geography rankings, and documentation-software buyer criteria.
The highest hourly number is not always the best offer. Productivity, cancellations, documentation time, benefits, commute, mentorship, and schedule control can change the real value.
Convert every offer into a comparable weekly model before negotiating.
The strongest offer is usually the one that fits your setting goals, protects clinical quality, and gives you enough support to stay.
Convert pay into real weekly value
OT offers can be hourly, salaried, per visit, per diem, contract, school-year, travel, or productivity-influenced. Compare them only after translating each into expected weekly income and unpaid time.
- Estimate documentation, meetings, commute, cancellations, chart review, and care coordination time.
- Ask how non-billable work is paid and how productivity is calculated.
- Compare PTO, holidays, health insurance, retirement match, continuing education, and license reimbursement.
Interrogate productivity and documentation
A job with attractive pay can become unsustainable if documentation, productivity, or payer rules are unrealistic. The documentation system and support model are part of the offer.
- Ask for the expected daily caseload, productivity target, and average documentation time.
- Ask which documentation platform is used and what templates, QA support, or AI tools are available.
- Ask how productivity is handled during cancellations, low census, IEP meetings, discharge planning, or complex cases.
Check mentorship and clinical fit
Early-career clinicians should treat mentorship as compensation. Experienced clinicians should treat autonomy and specialty support as part of the offer.
- Ask who reviews your work, how often you meet, and what happens when you need help.
- Ask whether the caseload matches the specialty advertised in the job posting.
- Ask about continuing education, certification support, equipment, and interdisciplinary collaboration.
Use market data to negotiate
State and metro wage data give you an external reference point. The right question is not just whether the offer is above average; it is whether it matches the setting, local cost, experience level, and workload.
- Compare the offer against the setting and metro most similar to the job.
- Use market rankings to identify whether you have relocation or alternative-employer leverage.
- Negotiate the variables that matter most: pay, schedule, documentation time, mentorship, mileage, caseload, or CEU support.