Occupational Therapist Salary in 2026: What Occupational Therapists Earn
Occupational therapy is one of the steadier, better-paid careers in American healthcare. Occupational therapists (OTs) held about 160,000 jobs in 2024, and according to the U.S. Bureau of Labor Statistics (BLS), they earn a median wage close to double the national average for all jobs. Unlike physical therapists, who focus on movement and pain, OTs help people build the skills they need for daily living and working — getting dressed after a stroke, returning to a job after an injury, or helping a child engage at school.
This guide breaks down what OTs actually earn in 2026 — the national median, how pay shifts with work setting and experience, and how location changes the number. All figures come from the most recent BLS data (the May 2024 release).
What the typical occupational therapist earns
The median annual wage for occupational therapists was $98,340 in May 2024. Median means half of all OTs earned more than that figure and half earned less. For comparison, the median wage across all U.S. occupations was $49,500.
The full range is wide:
- The lowest-paid 10% of OTs earned less than $67,090.
- The highest-paid 10% earned more than $129,830.
That spread — roughly $67,000 to $130,000 — is the most important thing to understand about OT pay. "OT salary" is not a single number; it depends heavily on where a therapist works, how long they have been working, and what they specialize in.
Occupational therapist pay by work setting
Where an OT works is one of the biggest factors in pay. BLS reports these median wages by employer type:
| Work setting | Median OT pay (2024) |
|---|---|
| Nursing care facilities (skilled nursing) | $103,210 |
| Home healthcare services | $103,010 |
| Hospitals (state, local & private) | $100,770 |
| Offices of physical, occupational and speech therapists | $96,380 |
| Educational services (state, local & private) | $83,890 |
Hospitals employ the largest share of OTs — about 28% — followed closely by therapist offices and outpatient clinics at 27%. Educational services employ another 13%, home healthcare about 8%, and nursing care facilities about 7%. The highest-paying settings are skilled nursing facilities and home healthcare, both of which pay above $103,000 at the median; both reflect a mix of higher patient acuity, more autonomous caseloads, and demand pressure from the aging population. Hospitals sit just below at around $100,000, paying close to the national median for the profession. The lowest among major settings is education, which includes school-based OTs working with children in K-12 systems and is tied to public-school pay scales and the academic calendar. The gap between the top and bottom setting is nearly $20,000 a year for the same core credential.
Experience and specialty
The other major factor is experience. New-graduate OTs typically start near the lower end of the range, while therapists with years of experience — especially in high-acuity rehab settings or in home health where caseloads can be more autonomous — earn toward the top.
Specialty also matters. The American Occupational Therapy Association offers board certifications in areas including pediatrics, gerontology, mental health, and physical rehabilitation, plus specialty certifications in driving and community mobility, environmental modification, feeding/eating/swallowing, low vision, and school systems. Therapists who earn these credentials and build a clinical niche — particularly in pediatrics, hand therapy, or geriatric home health — often command higher pay than generalists at the same experience level. Hand therapists who also earn the Certified Hand Therapist (CHT) credential, awarded through the Hand Therapy Certification Commission, frequently sit near the upper end of the wage range, especially in outpatient orthopedic clinics. Moving into supervisory, program-director, rehab-manager, or clinical-education roles is another path to the top of the range, as is per-diem and contract work in home health, where hourly rates are typically higher in exchange for fewer benefits.
Where occupational therapists earn the most
OT wages vary widely from state to state, and even between metro areas within the same state. Two forces drive that: local cost of living and local demand for therapists. A median wage in a high-cost coastal metro can sit tens of thousands of dollars above the same role in a lower-cost rural area, while some rural and home-health markets pay a premium to attract OTs to underserved regions. State-level licensing rules and the local mix of work settings — for example, a state with more large hospital systems and home-health agencies versus one that relies more on school-based OT — also tilt the local median.
Because those figures are updated every year and differ for all 50 states, the most reliable source for a location-specific number is the BLS Occupational Employment and Wage Statistics program, which publishes median OT wages for every state and metropolitan area. Anyone weighing an OT job offer should check the figure for their specific state and city rather than relying on the national median, and should weigh that local wage against local housing and commute costs before comparing offers across regions.
The job outlook for occupational therapists
Pay is only half the picture; job security is the other. BLS projects employment of occupational therapists to grow 14% from 2024 to 2034, much faster than the 3% average for all occupations, with about 10,200 openings every year over the decade. An aging population is the central driver: older adults are more likely to experience disabilities and limitations in daily activities, and more OTs will be needed to help them maintain independence at home, in nursing care, and after surgery. Demand also continues for OT services in pediatric care — including therapy for children with autism spectrum disorder and other developmental conditions — and in stroke, traumatic injury, and limb-loss rehabilitation. Many of the annual openings come from the need to replace OTs who transfer to other occupations or retire, which means hiring stays steady even in years without rapid net growth. For a profession this well paid, that is an unusually strong outlook.
How occupational therapists qualify
Occupational therapists reach the role through a graduate program. A master's degree in occupational therapy (MSOT or MOT) is the typical entry-level credential; the entry-level Doctor of Occupational Therapy (OTD) is a growing alternative that some new therapists choose for the additional clinical and research training. Master's programs usually take two to three years to complete and cover kinesiology, neuroscience, and anatomy, along with a required number of supervised fieldwork hours. Admission generally requires a bachelor's degree — not necessarily in a specific field, but with prerequisites in biology, psychology, and other sciences. After graduating from an accredited program, candidates must pass the national certifying exam administered by the National Board for Certification in Occupational Therapy (NBCOT) to use the title "Occupational Therapist Registered" (OTR). Every state also requires OTs to hold a license to practice, and most require continuing education to maintain it. Some employers additionally ask new hires to hold cardiopulmonary resuscitation (CPR) or basic life support (BLS) certification.
A note on your OT diploma
An occupational therapy diploma is a credential many OTs want to display once they have earned it. If your original has been lost or damaged, your OT program can issue an official replacement for any formal purpose. For a framed copy to hang at home or in an office, DiplomaCraft also offers replica graduate diplomas for display and novelty use.
Sources
- Wage, employment, and outlook data: U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Occupational Therapists, reflecting the May 2024 Occupational Employment and Wage Statistics release (updated August 2025).
- State and metro wage data: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS).
All wage figures are medians and reflect the most recent BLS data available as of 2026. Actual pay varies by employer, location, experience, and specialty.