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What setting do occupational therapists make the most money

Are you just starting out your OT career and are looking for information about the best paying states for occupational therapists? Maybe you have years of experience and are looking for a change in scenery and a better pay grade? No matter where you are on your OT job search journey, you’ve come to the right place!

One of the greatest aspects of OT in the U.S. is the flexibility in the OT job market compared to many other professions. You could go just about anywhere in the country where there are people!

No matter where you go, you’ll first need to figure out licensing, which is not such a hurdle that should necessarily influence your decision about where to move. (For OT licensing information state by state, be sure to check out our all-inclusive guide here).

So Where Can You Get Paid The Most?

Everyone tells you that following the money is a bad idea. But, it is likely an important factor in your decision, so we will take a closer look at it in this post.

Because, after all, you won’t be working your heart out for nothing. Your skills are valuable and OT facilities will and should compensate you for your expertise.

So let’s ask the question:

Where in the U.S. could you go work fresh out of OT school in order to get paid the most for your services?

Of course, there are many more important factors when evaluating whether or not you want to live in a city long term. Everyone holds different things as important to them.

For this post, we’ll look at 3 different considerations:

  1. Top Paying States for OTs
  2. Best Paying OT Settings/Positions
  3. Saturation of OTs

Some other things you will want to consider, but that we’re not covering here, include things like a city’s culture, typical commutes, entertainment options, outdoor activities, public services, not to mention the weather and proximity to the beach or mountains!


Consideration #1: Top 5 Paying States for OTs

The Bureau of Labor Statistics (BLS) lists the following 5 states as the best paying states for OTRs as of May 2020. Refer to this cost of living index for a high level view of the cost of living by state. You definitely have to balance net pay and living expenses to ascertain whether or not it’s worth it to live in a state for the higher salary.

5. District of Columbia

The nation’s capital comes in the 5th spot with an annual average salary of $96,330 ($46.31/hr) for occupational therapists. While it does pay really well, as many people know Washington D.C. also has a high cost of living. Washington D.C. ranks #2 for when ranked against all other U.S. states. Only Hawaii is more expensive. 

That said, there’s a reason so many people want to live in the D.C. area. The culture is very diverse, there’s a wide range of activities and history everywhere you go, the weather is mild, and it’s centrally located on the east coast. I personally know several people that have lived in D.C. and absolutely loved it. The additional cost of living may be worth it in this case. 

4. Arizona

Arizona’s average annual pay of $99,950 ($48.05/hr) is just slightly higher than D.C. What makes this level of pay so remarkable is Arizona’s relatively low cost of living compared to some of the other states on this list. The state ranks 23rd – right in the middle – for average cost of living.

What’s more is that Arizona is an absolutely beautiful state. On our fall road trip in 2018, we spent some time in Arizona and were absolutely blown away. You’ve got the legendary Grand Canyon in the north, the one-of-a-kind Sedona in the northeast, and the amazing Saguaro National Park just outside of Tucson. It can get very hot in Arizona and it’s far from many other U.S. regions, but you’ll be paid well and there are so many great places to see! 

3. New Jersey

The Garden State offers an average annual salary up to $98,750 ($47.48/hr). As of 2021, home prices in New Jersey averaged $615,738, monthly energy bills at $186, and a grade F on the Cost of Living score ( which qualifies New Jersey as being in the top 10 most expensive states in the country.

If you live in the northeast already and are looking to stay close to family friends, you may still want to consider New Jersey. If moving to New Jersey doesn’t drastically change your cost of living, it might still make sense for you economically if you find a higher paying OT job.

2. California

With an average annual salary of $101,080 ($48.59/hr), beautiful weather, and world-famous beaches, it’s no wonder so many OTs dream of moving to the Sunshine State. 

California of course is the most populous state in the U.S. with rich culture, landscapes, and 840 miles of breathtaking coastline. There are just too many great things in California to ever be able to sum it up succinctly. As most people are aware though, the cost of living is one of the highest. You are paying for what you get here. You won’t be able to save as much as some other states, but you may be rewarded in other ways. 

1. Nevada

Nevada offers the highest paying average annual salary of $111,270 ($50.70/hr) as of May 2020. While many people might just think of Las Vegas when they hear about Nevada, this state has so much more to offer, with beautiful desert, canyon and mountain landscapes to give you plenty of outdoor activity options.

Relatively speaking, Nevada is right in the middle of the road: not too expensive, but also not the cheapest. Nevada is also the only state on the list that has no individual income tax. It’s safe to say, you’ll be able to save a tremendous amount and pay off your student loans much more quickly living here. 

If your goal is to try to make as much money as possible coming out of OT school while not having to spend a ton to survive, the best states for you are Arizona or Nevada.


Consideration #2: Best Paying Clinical Settings

Since this post is solely focused on income and cost of living, one other factor that is vitally important to consider is what clinical settings pay the best.

Common settings include outpatient, school settings, early intervention, skilled nursing settings, hospital settings, home health, etc. To learn more about all of the different OT settings, be sure to check out our article, The 13 Most Common Occupational Therapy Settings.

According to AOTA’s latest Salary and Workforce Survey from 2019, the highest paid settings for occupational therapists include home health and long term care/skilled nursing facilities. Of course, pay per settings also varies depending on your years of experience and academic credentials.

While home health, long-term care, and skilled nursing facilities pay well, you should always do your research into these settings to see if they are right for you.

Overall Highest Paid Occupational Therapy Positions

In 2020, the BLS found the following OT positions to be the highest paying (yearly salary average):

  1. “Child Day Care Services” – $108,650
  2. Management of Companies and Enterprises – $101,540
  3. Retirement Communities and Assisted Living Facilities – $93,870
  4. Nursing and Skilled Nursing Facilities – $90,660
  5. Home Health Services – $90,480

Note that “Management of Companies and Enterprises” include outpatient and contract therapy companies, and the BLS does not specify what pediatric settings entail Child Day Care Services.

Management positions pay more in the OT field since many management jobs across the country require a certain number of years of clinical experience prior to applying.


Consideration #3: How Saturated Is The Market?

When it comes to pay and likelihood of employment, the last item to consider is market saturation.

On the bright side, the BLS states that occupational therapy employment in the U.S. will have a 29% increase from 2012-2022, so our careers are in a safe zone for a while.

However, you may still have to compete with fellow graduates across the country for the jobs you want in the most desirable locations.

In 2019, the states with the highest number of employed OTs include New York, California, Texas, Pennsylvania, and Florida. This should come as no surprise since those states are the most heavily populated in the country. In addition, availability of employment is lower than the national average in California, New York, and Florida.

The states with the most OT jobs per capita were Connecticut, Maine, New Hampshire, Delaware, and New York. While none of these states made the list, they may present a better opportunity in terms of the availability of jobs for OTs.


Key Takeaways

While money isn’t the only thing to think about when deciding where to move for work, it is certainly a component of most people’s decision. High paying states with low costs of living, like Arizona and Nevada, present a great opportunity for occupational therapists willing to move for work.

When it comes to pay, it’s also important to take into account the setting you will work in. Skilled Nursing Facilities tend to pay more on average, but be sure that setting is a good fit for you before jumping in.

Finally, think about how much competition there is in the state and city you’re thinking of moving to. A state may be high paying, but there also may be a lot of OTs trying to get jobs there.

If you have a state in mind you want to move to, dig into the data at BLS, calculate the cost of living compared to where you currently live, and research how many OT programs there are close by. More OT programs in close proximity means the potential for saturation in the market.


Bureau of Labor Statistics:

Cost of Living Calculator:

Cost of Living Index by State:

This post was originally published on July 4, 2017 and updated on April 20, 2020 and January 27, 2022. Thanks so much to Meredith Chandler, OTR/L for her immense help co-authoring the original article!