Salary ranking

Highest-Paying Occupational Therapy Settings

Compare the major occupational therapist work settings by BLS-published median annual wage, then read the practical tradeoffs that matter before choosing a job.

BLS wagesOT settingsCareer tradeoffsMay 2024

Ranking table

OT settings ranked by median annual wage

Official data is kept separate from The OT Index scoring and interpretation so readers can see what is measured and what is judgment.

RankOptionScoreMedian annual wageThe OT Index readBest forWatch out for
1Nursing care facilitiesA$103,210Highest published major-setting medianClinicians who want strong pay and frequent rehab volume.Expect productivity pressure, heavy documentation, and variable staffing models.
2Home healthcare servicesA$103,010Nearly tied with nursing care facilitiesOTs who value autonomy, aging-in-place work, and schedule control.Travel time, cancellations, and visit density can change the real hourly value.
3HospitalsA-$100,770Strong pay plus acute-care exposureNew grads and clinicians building broad medical complexity skills.Weekend rotations, fast discharge planning, and census swings are common.
4Therapy officesB+$96,380Outpatient and specialty upsideOTs pursuing hands, neuro, pediatrics, ergonomics, or private-practice paths.Pay varies sharply by specialty, ownership model, and local referral base.
5Educational servicesB$83,890Lower pay, often stronger calendar qualityOTs who prefer pediatrics, school calendars, and team-based IEP work.Caseload size, district support, and documentation systems can make or break fit.

Methodology

How this ranking is weighted

Each ranking has its own weighting model. The table below shows the factors readers should consider before treating any rank as a final answer.

Published wage55%

BLS median annual wage is the primary ranking signal for this page.

Career flexibility20%

Autonomy, setting portability, and room to specialize after entry.

Schedule quality15%

Predictability, weekend burden, school-year options, and travel demands.

Documentation burden10%

How much non-treatment work can reduce the practical value of the role.