You have finally graduated from your OT program and are approaching your NBCOT test dates.

In the midst of your intense studies, you are plunging into the job search in anticipation to pay off your exorbitant student loans and to make a name for yourself in the clinical world.

Rightfully so, it is an exciting time in your life since OT jobs are spread near and far across the U.S.

In the U.S., there is decent flexibility in the job market compared to other professions. You could go just about anywhere in the country where there are people!

No matter where you go, you’ll need to figure out licensing. But I don’t think it’s such a huge hurdle that it should necessarily influence your decision about where to move.

Where Can You Get Paid The Most?

Everyone tells you that following the money is a bad idea. But, it is a 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 hearts out for nothing. Your skills are valuable and medical 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?

To answer this question, we will look at the highest paying states in the U.S. But, we will also touch on a few other critical and related factors:

  • Best Paying Settings
  • Best Paying Positions
  • Market Saturation of OTs

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.

Some other things you will consider, but 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!

Top 5 Paying States

The Bureau of Labor Statistics (BLS) listed the following 5 states as the best paying states for OTRs as of 2016.

Each state listed provides information about wages as well as recent statistics regarding cost-of-living since you have to balance net pay and living expenses to ascertain whether or not your salary is worth it.

1. Nevada

Nevada offers the highest paying salary annually as of 2016, averaging $101,870. The hourly wage equates to $48.98 (BLS).

According to, housing in Nevada is cheaper than the national average if you’re looking for a typical apartment. However, your cost of living will also include things like groceries, medical care, transportation, and utilities that are a bit higher than the national average in some parts of the state.

Relatively speaking though, Nevada is right in the middle of the road: not too expensive, but also not the cheapest.

2. Texas

The Lone Star State offers the second highest salary at $96,800 with an hourly wage of $46.54 (BLS).

Being the huge state that it is, there is a lot of economic diversity across regions and from city to city. Overall, the cost of living for the state in 2016 was lower than the national average (

The largest and most popular cities in Texas are Austin, Dallas/Fort-Worth, San Antonio, and Houston. Austin and Dallas are two of the fastest growing cities in the U.S. which means high job growth and opportunity, but also high competition and slightly higher cost of living.

If you want to live in a big city but cost of living is also very important to you, you might consider Houston. shows that the cost-of-living in Houston is 10% lower than the national average.

3. New Jersey

The Garden State offers an annual salary up to $91,660 with an hourly wage of $44.07 (BLS). As of 2016, home prices in New Jersey averaged $521,000, monthly energy bills at $184, and health bills at almost $100 per visit ( 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 job.

4. Virginia

Virginia positions average $91,450 annually with an hourly wage of $43.97 (BLS). Virginia is right around the national average in terms of the cost of living. However, the overall median price of a home is higher than the national average. If you’re thinking of living in Falls Church or Alexandria, home prices range from $500,000-$800,000 as of 2017.

5. Connecticut

Lastly, Connecticut offers up to $89,340 with an hourly wage averaging at $42.95 (BLS). Home prices average at $626,000, monthly energy bill at $268, and a doctor’s visit at $123. According to, Connecticut is the most expensive state in terms of cost of living.

There is one good reason you still might want to work in Connecticut though, which you’ll find further down the page.


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 Texas or Nevada.

Refer to this map for the 2017 average cost of living in all U.S. states.


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 setting, home health, etc. For more about popular adult settings, read Navigating Through The Occupational Therapy Continuum Of Care.

According to, the highest paid settings in 2015 for occupational therapists include home health and long term care/skilled nursing facilities. Of course, pay per settings also varies depending on years of experience and academic credentials.

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

Overall Highest Paid Occupational Therapy Positions

Interestingly, 3 of the 4 highest paid positions in occupational therapy are not clinical at all. Rather, they are in management and teaching.

In 2016, the BLS found the following OT positions to be the highest paying (yearly salary average):

1. Management, Scientific, and Technical Consulting: $98,680

2. Schools and Instruction: $94,530

3. Management of Companies and Enterprises: $94,160

4. Skilled Nursing Facilities: $90,230

A few things to note:

The schools and instruction statistic is referring to professorial positions and not elementary/secondary schooling settings. Management of companies and Enterprises include outpatient and contract therapy companies.

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.

Finally, How Saturated Is The City?

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 2016, the states with the highest number of employed OTs included California, Texas, Florida, New York, and Pennsylvania. 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, Texas, and Florida.

In 2016, the following 5 states were rated the highest in job availability for OTs: New Hampshire, Maine, Massachusetts, Connecticut, and Michigan.

If you refer back to the beginning of this article, you’ll notice that Connecticut is listed as one of the top-paying states. Sure, you’ll be paying much more to live there, but competition for a job will be much less.

What do we learn from all of this?

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 Texas 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 it’s 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.


Cost of Living Calculator:

Bureau of Labor Statistics:

Advance Web Statistics:

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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.

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