How to Become a Occupational Therapist
Occupational Therapists earn a median salary of $100,330/year in the United States. Most positions require Master's degree. Job growth is projected at 12% over the next decade. The highest-paying states include California, Oregon, Nevada.
Where Occupational Therapists have the most money left over after rent
Median pay minus estimated federal + state + FICA taxes, minus 12 months of rent at HUD's 2-bedroom Fair Market Rent. Darker green means more money left over each year. Hover any state for the breakdown.
View map data as a table
| State | Median (nominal) | Rent/mo (2BR) | Left after rent |
|---|---|---|---|
| Nevada | $111K | $1,501 | $68K |
| Arkansas | $106K | $1,021 | $67K |
| Texas | $106K | $1,415 | $66K |
| Oklahoma | $104K | $1,081 | $64K |
| Tennessee | $98K | $1,215 | $63K |
| Ohio | $99K | $1,188 | $62K |
| Washington | $108K | $1,830 | $62K |
| Alaska | $104K | $1,643 | $62K |
| New Mexico | $99K | $1,119 | $61K |
| Arizona | $104K | $1,437 | $61K |
| Indiana | $97K | $1,144 | $60K |
| Kansas | $99K | $1,066 | $60K |
| Kentucky | $98K | $1,110 | $60K |
| Louisiana | $98K | $1,191 | $60K |
| Missouri | $97K | $1,097 | $60K |
| South Carolina | $101K | $1,263 | $60K |
| West Virginia | $96K | $1,008 | $60K |
| Georgia | $104K | $1,434 | $59K |
| Idaho | $98K | $1,136 | $59K |
| Oregon | $112K | $1,555 | $59K |
| Florida | $99K | $1,658 | $58K |
| Mississippi | $95K | $1,077 | $58K |
| Pennsylvania | $98K | $1,351 | $58K |
| California | $125K | $2,471 | $58K |
| Delaware | $102K | $1,448 | $57K |
| Illinois | $100K | $1,407 | $57K |
| Maryland | $107K | $1,795 | $57K |
| Nebraska | $94K | $1,113 | $57K |
| Rhode Island | $100K | $1,544 | $57K |
| Wyoming | $86K | $1,008 | $57K |
| Colorado | $107K | $1,832 | $57K |
| Alabama | $94K | $1,085 | $57K |
| South Dakota | $85K | $1,017 | $56K |
| Utah | $97K | $1,350 | $56K |
| Wisconsin | $92K | $1,202 | $55K |
| Connecticut | $102K | $1,679 | $55K |
| Iowa | $90K | $1,064 | $54K |
| North Carolina | $93K | $1,284 | $54K |
| Virginia | $101K | $1,646 | $54K |
| District of Columbia | $109K | $2,146 | $53K |
| Michigan | $90K | $1,272 | $53K |
| Montana | $89K | $1,129 | $53K |
| North Dakota | $83K | $1,034 | $53K |
| Minnesota | $93K | $1,384 | $52K |
| New Jersey | $103K | $2,067 | $52K |
| Vermont | $93K | $1,498 | $52K |
| New Hampshire | $84K | $1,528 | $49K |
| Maine | $84K | $1,281 | $48K |
| New York | $96K | $1,917 | $48K |
| Hawaii | $103K | $2,240 | $46K |
| Massachusetts | $101K | $2,347 | $46K |
Education and training
OTs require a master's degree from an ACOTE-accredited program (typically 2-3 years after a bachelor's degree with prerequisites in anatomy, physiology, psychology, and statistics. The entry-level OTD (Doctor of Occupational Therapy) is becoming more common but is not yet required. Clinical fieldwork totals 24+ weeks of supervised practice.
Total cost: $60,000-$120,000 for the master's program. Combined with undergraduate debt, $80,000-$150,000 total educational investment is typical.
Fieldwork experiences are divided into Level I (observation and supervised participation, integrated throughout coursework) and Level II (full-time immersive practice, typically two 12-week rotations in different settings). Finding fieldwork placements can be challenging, demand for OT fieldwork sites exceeds supply in many regions, and students sometimes need to relocate temporarily for rotations.
Licensing and certification
OTs must pass the NBCOT (National Board for Certification in Occupational Therapy) exam. State licensure is required in all 50 states and is typically contingent on NBCOT certification. Continuing education requirements vary: 24-36 hours per 2-year cycle in most states.
Specialty certifications through AOTA (hand therapy, driving rehabilitation, low vision, environmental modification) are voluntary but can command $3,000-$8,000/year salary premiums.
What the day-to-day looks like
OTs help patients regain the ability to perform daily activities, dressing, bathing, cooking, working, driving, after injury, illness, disability, or surgery. Unlike PTs (who focus on movement and strength), OTs focus on functional independence in real-world tasks.
Settings include hospitals (acute care and inpatient rehab), outpatient clinics, schools (pediatric OT is a major specialty), skilled nursing facilities, home health, and mental health facilities. Pediatric OTs work with children on fine motor skills, sensory processing, handwriting, and self-care skills. Adult OTs often specialize in hand therapy, neuro rehabilitation, or workplace ergonomics.
Caseload varies by setting: acute care OTs see 6-8 patients/day; outpatient OTs see 8-12; school-based OTs carry caseloads of 40-60 students with varying visit frequencies.
The creativity of OT is its defining feature. You're not running patients through standardized exercise protocols, you're figuring out how to help a stroke survivor button their shirt again, how to modify a classroom for a child with sensory processing difficulties, or how to redesign a kitchen so someone in a wheelchair can cook independently. Each patient's goals and environment are unique, which makes the work intellectually engaging but also demanding. Documentation and insurance justification consume significant time, proving to payers that therapy is "medically necessary" requires careful language and measurable goals.
Career progression
New OT → senior clinician → clinical specialist → rehab director. Certified Hand Therapists (CHT) earn among the highest OT salaries ($90,000-$110,000) due to the additional 4,000+ hours of hand therapy experience and a separate certification exam.
Travel OT positions pay $1,600-$2,200/week gross. School-based OT follows the academic calendar (summers off) at lower pay. Private practice OT removes the salary ceiling but requires business development skills.
Salary progression
Highest paying states
| State | Median salary | Employment |
|---|---|---|
| California | $125K | 13,810 |
| Oregon | $112K | 1,170 |
| Nevada | $111K | 1,080 |
| District of Columbia | $109K | 540 |
| Washington | $108K | 3,340 |
| Maryland | $107K | 2,390 |
| Colorado | $107K | 3,390 |
| Arkansas | $106K | 2,160 |
| Texas | $106K | 13,400 |
| Oklahoma | $104K | 1,180 |
Where the jobs are
The highest-paying state for occupational therapistss is California at $124,510/year, that's $24,180 above the national median. But higher pay often comes with higher costs. Before assuming the top-paying state is the best financial move, check the full affordability breakdown for California.
The pay gap between the highest and lowest-paying states is $41,310. That spread sounds dramatic, but cost-of-living differences offset much of it. A occupational therapists making $83,200 in North Dakota may have more purchasing power than one making $124,510 in California if rent and local prices differ enough.
By employment volume, the states with the most occupational therapists jobs are California (13,810 workers), Texas (13,400 workers), New York (11,690 workers). High employment numbers mean more job openings, more employer competition for talent, and usually more leverage when negotiating salary. States with fewer workers in the field may pay less but also have less competition for positions.
For the full state-by-state comparison with salary percentiles, cost-of-living adjustment, and rent affordability for occupational therapistss, see the complete salary data page.
Salary negotiation
OT demand is strong in schools, SNFs, and home health. The strongest levers: pediatric experience with sensory processing and autism spectrum disorders (high-demand niche), hand therapy certification, and willingness to serve rural school districts where OTs are scarce. Many school districts offer student loan forgiveness as a recruitment tool for OTs.
What the data doesn't tell you
OT is often confused with PT by the public, but the roles differ substantially. The simplest distinction: PTs restore physical function (can you walk?), OTs restore daily function (can you button your shirt?). OT's broader scope, including mental health, cognition, and environmental adaptation, makes it more versatile but also harder to explain to people unfamiliar with the profession.
See the full salary picture
Percentile breakdown, cost of living, rent burden, and purchasing power for occupational therapistss in every metro.
View Occupational Therapists salaries →Frequently asked questions
How much does a occupational therapists make?▼
The median occupational therapists salary in the United States is $100,330 per year ($48/hour). Entry-level positions start around $71,690, while experienced professionals earn up to $131,950.
What education do you need to become a occupational therapist?▼
Most occupational therapists positions require Master's degree. Requirements vary by state and employer. Check with your state's licensing board for specific requirements.
What is the job outlook for occupational therapists?▼
Employment of occupational therapists is projected to grow 12% over the next decade, with approximately 1,580 annual openings. This is faster than the average for all occupations.
What are the highest paying states for occupational therapists?▼
The highest paying states for occupational therapists are California ($124,510), Oregon ($112,310), Nevada ($110,520), District of Columbia ($109,170), Washington ($107,670). Salaries vary significantly by location due to cost of living and local demand.