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 Occupational Therapists
  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 OTs as of May 2022. 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. Virginia

Virginia is new to this list this year, taking the 5th spot with an annual average salary of $97,980 ($47.11/hour) for occupational therapists.

With a more average cost of living (102.6 in 2022, only slightly higher than the national average of 100, according to MERIC) than other states on this list, it can be an affordable option with a lot to do.

Along with the vast history and culture this state has, there is also so much to do outdoors. Virginia has a diverse landscape, including the Blue Ridge Mountains, Chesapeake Bay, and Atlantic Ocean.

If you like to be outside, there are plenty of opportunities for outdoor recreation, including hiking, camping, fishing, and water sports. No wonder U.S. News ranks Virginia as 7th for overall quality of life, something to keep in mind if you want to relocate for your next OT job.

4. Alaska

Also a new addition to this list this year is Alaska. If you’re ready for a big adventure move, Alaska pays OTs very well, with an annual average pay of $100,810 ($48.46/hour)

In my opinion, Alaska has some of the world’s most beautiful landscapes, with its breathtaking glaciers, mountains, lakes and wildlife. So if you don’t mind the very cold winters but love the outdoors, this would be an absolutely amazing place to work as an OT.

A big thing to keep in mind, though, is the high cost of living here. It’s not only expensive to fly back to the contiguous U.S. but the overall cost of living is high due to its remote location and harsh weather conditions, making it more expensive to transport goods and provide services. But at least there’s no state sales tax or income tax!

3. New Jersey

The Garden State offers an average annual salary up to $104,710 ($50.34/hour). 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. Nevada

Nevada, dropping from the first spot, is now the second-highest paying average annual salary of $105,020 ($50.49/hour) as of May 2022. 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 other 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. (While Arizona is no longer in the top 5 best paying states for OTs, it still offers better than average pay with a slightly above average cost of living.)

1. California

With an average annual salary of $109,220 ($52.51/hour), 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 you are probably aware though, the cost of living here is one of the highest in the country. You are paying for what you get here. You probably won’t be able to save as much as some other states, but you may be rewarded in other ways. 


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, 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 2022, the states with the highest number of employed occupational therapists 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 May 10, 2023. Thanks so much to Meredith Chandler, OTR/L for her immense help co-authoring the original article!

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  • B December 26, 2019   Reply →

    Good article. I am an OT with 20 plus years experience. Looking to relocate to a city with better cost of living than NY. I love NY but it is very expensive.

  • Lori February 20, 2020   Reply →

    I am wondering what year this article found the information because I am licensed in both MA and CT and the jobs are scarce, market is saturated with OT’s. There are 14 schools in both states Combined that graduate OT’s every year. There are many recent graduates struggling to find employment. For many jobs there are 30 applicants vying for the position and it is also driving down the salaries. Someone will always work for less. If you are willing to live near the T-line outside of Boston ( median home prices are between 600,000-1,000,000$ Plus) there are slightly more options due to the amount of hospitals in that area. Personally if someone is considering moving here for that reason I would scratch MA and CT off that list.

    • Sarah Stromsdorfer, OTR/L February 21, 2020   Reply →

      Thank you for sharing! This article was written in 2017 but will be updated this early this year with the latest numbers.

    • Eileen Elmendorf May 20, 2021   Reply →

      Is it possible to trail an OT at a Veterans Hospital? I am practicing now but am considering a switch, but would like to experience the working conditions first hand.

  • sea July 24, 2020   Reply →

    You should make a quiz for new grads or students to take where they figure out which OT setting might fit them best. Example: working in home health= ability to travel from, patient type, etc. , inpatient= hours, patient type, etc. and so on. 🙂

    • Sarah Stromsdorfer, OTR/L July 26, 2020   Reply →

      That’s a great idea, I’ll definitely look into how I can do that 🙂 Thanks for the suggestion!

  • Lia July 30, 2020   Reply →

    I was wondering what type of setting/ specific OT job would fall under “Child Day Care Services” ?

    • Sarah Stromsdorfer, OTR/L July 30, 2020   Reply →

      Unfortunately the BLS does not specify what pediatric settings entail “Child Day Care Services,” but our best guess that it would include all or most pediatric settings such as outpatient, inpatient, home health, early intervention and school-based occupational therapy. But again, they don’t state the specifics anywhere on their metrics so the best we can do is take a guess at this point. Hoping we get a more detailed update next year!

  • Andres September 25, 2022   Reply →

    Hola!! Alguien que haya validado su profesión en EEUU. Gracias.

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