Occupational therapists (OTs or OTRs—the “r” stands for “registered”) play an essential role in the health professions. When injuries and illnesses rob people of their capacity for self-care or individuals with disabilities seek more independence, OTs help them learn or relearn the kinds of routine, everyday activities most of us take for granted.
Occupational therapists are among only people in the world who understand how complex seemingly straightforward activities can be. You probably don’t realize it, but even preparing a bowl of cereal or putting away laundry involves numerous motor processes, sensory input processing skills, bilateral coordination, and motor planning. When those processes break down, OTs arrive on the scene to help.
Thanks to their rigorous training, OTs know how challenging simple daily tasks can be for people with neurological or physical differences. The entry-level education to become an occupational therapist is a two-year master’s degree. The Master of Occupational Therapy (MOT) isn’t the terminal degree in the field, however. Some OTs pursue the Doctor of Occupational Therapy degree(OTD)—either as their entry-level credential or as a post-professional credential.
You don’t need an OTD to work in clinical roles in occupational therapy, though there’s a chance you might need one in the future. The Accreditation Council for Occupational Therapy Education (ACOTE) has recommended that all entry-level occupational therapy programs transition to the doctoral level. However, it has never gone as far as mandating that the OTD become the entry-level degree for the field.
There are good reasons to pursue an OTD, but salary may not be one of them. Occupational therapy jobs pay well—about $86,000 annually as of 2021, according to the Bureau of Labor Statistics—and are relatively stable, but that’s irrespective of highest level of education achieved.
In this article, we look at the factors that impact Doctor of Occupational Therapy salaries and cover:
The Doctor of Occupational Therapy is a practice-oriented professional doctorate designed for clinical OTs. There are two types of OTD programs:
Until fairly recently, most Doctor of Occupational Therapy programs were designed for OTs who already meet licensure requirements. However, the number of online and on-campus entry-level OTD programs is growing. There are around 40 entry-level AOTA-accredited OTD degree programs in the United States. The list of post-professional OTD programs recognized by AOTA is quite a bit longer. You can check the accreditation status of any program at the ACOTE website.
Both OTD pathways include core classes in:
Some programs require students to complete a three-credit-hour capstone course or write a thesis. Students in both types of program complete a minimum of 24 weeks of full-time supervised Level II fieldwork—ideally in a variety of clinical settings.
The big difference between these two academic programs can be found in the scope of the material covered. Entry-level doctorate programs cover a broad range of topics primarily focused on issues related to clinical practices. Post-professional programs usually focus on leadership, assessment, and innovation.
At the University of Pittsburgh, for example, students in the three-year, nine-term entry-level OTD program take courses like:
Meanwhile, the core courses in the school’s online post-professional Doctor of Clinical Science in Occupational Therapy program include courses in:
Earning an OTD can help launch a career in occupational therapy (much like an MOT) or open up new career paths in teaching, research, and leadership positions in clinical settings. From a compensation standpoint, entry-level Doctor of Occupational Therapy salaries are very similar to MOT salaries. Earning a post-professional doctorate in occupational therapy may result in a salary increase (when it leads to a change in responsibilities).
The average salary of freshly minted OTs (those with one or fewer years work experience) is about $69,500. The same source places the median income calculated across all levels of experience is about $92,000. The BLS estimates a slightly lower value of $89,500.
None of these figures tells a complete story, however, because these averages don’t take education into account. Consequently, they’re not particularly useful when it comes to determining the value of a doctorate.
Salaries for occupational therapists also vary significantly by location. In Tennessee and New Jersey, OTs earn over $100,000 per year on average. In Georgia, OTs earn closer to $68,000.
Practice setting also plays a role in the earning potential of OTs. There are occupational therapists in hospitals, outpatient clinics, schools, home health agencies, research facilities, and rehabilitation centers. OTs who provide in-home care tend to earn the most, while those who work in schools typically earn the least.
It’s unclear what role education plays in salary. It’s not unusual for OTs to start at the same point on the pay scale, whether they graduate from a master’s-level OT program or earn an entry-level Doctor of Occupational Therapy. The OTD holder may be able to advance through clinical positions more quickly because their education included coursework related to advanced clinical topics, management, and program development. There are also higher-paying administrative roles, research positions, and program development jobs that are only open to OTD holders. On the other hand, the MOT holder joins the workforce one year sooner, gaining valuable clinical experience, and may carry less student loan debt.
The quick answer to this question is: not yet. While ACOTE has delayed making the clinical doctorate for OTs the mandatory entry-level degree for licensure in this field, AOTA has been kicking around the idea for about two decades. In 2018, the organization nearly mandated that all MOT programs become OTD programs by 2027. However, a year later, it decided to table the mandate and continue to support dual entry-level degree pathways.
Aspiring OTs shouldn’t rule out the possibility that an OTD mandate will eventually go into effect. Licensed occupational therapy practitioners with master’s degrees would still be legally able to work. Still, a time might come when doctorate holders have more doors open to them and can earn more in clinical roles. That will be because they’ve been able to specialize in areas like gerontology, program development, pediatric occupational therapy, or administration.
According to US News and World Report, the best occupational therapy programs can be found at:
All of these schools have either entry-level or post-professional OTD programs accredited by ACOTE.
You might earn more with a doctorate of occupational therapy, provided you graduate from a post-professional program. In general, however, employers treat entry-level Doctor of Occupational Therapy degrees like MOTs.
Whether you have an OTD or an MOT, your professional experience will likely impact your salary more than the degree on your resume. Even AOTA, in its own materials, states outright that “preliminary informal surveys of entry-level doctoral graduates indicate that the doctoral degree does not guarantee advanced salaries.”
AOTA also wrote in the same report that “many entry-level doctoral graduates are able to pursue and fill unique positions due to their advanced education.” These positions, which can include roles in academia, administration, and scientific research, are often only open to doctorate holders and may pay more.
There are many things occupational therapists can do to make more money beyond getting an advanced degree. An OT might look for work in one of the states that tend to pay occupational therapists more, or in major metro areas where salaries are often higher. They might also apply for roles with home health agencies or travel OT positions, which usually pay more. Non-clinical roles are some of the highest-paying, so transitioning into administration can lead to a bigger paycheck.
Occupational therapists who find per diem employment sometimes command a higher hourly rate than occupational therapists in full-time positions, though be aware that per diem positions don’t come with PTO, health insurance, or other benefits. Other OTs boost their earning potential by specializing in a particular field of occupational therapy.
Another way to earn more, regardless of highest education achieved, is to pursue nationally recognized certifications or professional development training related to certain patient populations or specific therapies. There are many salary-boosting certifications OTs can pursue, including:
Finally, just keep working hard. At some point in your career in occupational therapy, your degree will become the least interesting thing on your resume. Your earning potential will hinge not on your education but on the quality of care you’re capable of delivering to your patients.
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