Healthcare · Rankings

Best US Cities for Occupational Therapists

Top US cities for Occupational Therapists ranked by estimated median salary, with cost-of-living-adjusted earning power.

Top 10 cities by salary

#	City	Estimated salary	Cost mult.	vs national
1	San Francisco, CA	$132,400	1.45×	+$37,400
2	Honolulu, HI	$127,700	1.30×	+$32,700
3	Oakland, CA	$125,400	1.35×	+$30,400
4	Irvine, CA	$121,900	1.30×	+$26,900
5	Boston, MA	$121,700	1.22×	+$26,700
6	Scottsdale, AZ	$118,800	1.18×	+$23,800
7	New York City, NY	$116,300	1.32×	+$21,300
8	San Diego, CA	$115,500	1.21×	+$20,500
9	Yonkers, NY	$114,800	1.20×	+$19,800
10	Anchorage, AK	$114,800	1.20×	+$19,800

All 50 cities, ranked

#	City	Salary	Hourly
1	San Francisco, CA	$132,400	$64/hr
2	Honolulu, HI	$127,700	$61/hr
3	Oakland, CA	$125,400	$60/hr
4	Irvine, CA	$121,900	$59/hr
5	Boston, MA	$121,700	$59/hr
6	Scottsdale, AZ	$118,800	$57/hr
7	New York City, NY	$116,300	$56/hr
8	San Diego, CA	$115,500	$56/hr
9	Yonkers, NY	$114,800	$55/hr
10	Anchorage, AK	$114,800	$55/hr
11	Miami, FL	$114,300	$55/hr
12	Seattle, WA	$113,400	$55/hr
13	Long Beach, CA	$113,400	$55/hr
14	Anaheim, CA	$113,400	$55/hr
15	Chula Vista, CA	$111,300	$54/hr
16	Los Angeles, CA	$109,600	$53/hr
17	Baltimore, MD	$109,100	$52/hr
18	Portland, OR	$107,800	$52/hr
19	Newark, NJ	$107,800	$52/hr
20	Sacramento, CA	$107,800	$52/hr
21	Riverside, CA	$107,800	$52/hr
22	Philadelphia, PA	$106,900	$51/hr
23	Henderson, NV	$106,900	$51/hr
24	Denver, CO	$106,300	$51/hr
25	Orlando, FL	$106,200	$51/hr
26	Raleigh, NC	$105,500	$51/hr
27	Worcester, MA	$105,500	$51/hr
28	Stockton, CA	$104,200	$50/hr
29	Aurora, CO	$104,200	$50/hr
30	Hialeah, FL	$104,200	$50/hr
31	Las Vegas, NV	$103,600	$50/hr
32	Minneapolis, MN	$103,600	$50/hr
33	Plano, TX	$103,600	$50/hr
34	Houston, TX	$102,500	$49/hr
35	Phoenix, AZ	$102,100	$49/hr
36	Tampa, FL	$102,100	$49/hr
37	Gilbert, AZ	$102,100	$49/hr
38	Salt Lake City, UT	$102,100	$49/hr
39	New Orleans, LA	$101,000	$49/hr
40	Wilmington, DE	$100,700	$48/hr
41	St. Paul, MN	$100,700	$48/hr
42	Boise, ID	$100,700	$48/hr
43	Fresno, CA	$100,700	$48/hr
44	Nashville, TN	$100,000	$48/hr
45	Colorado Springs, CO	$100,000	$48/hr
46	St. Petersburg, FL	$100,000	$48/hr
47	Madison, WI	$100,000	$48/hr
48	St. Louis, MO	$98,800	$48/hr
49	Winston-Salem, NC	$98,800	$48/hr
50	Jacksonville, FL	$98,600	$47/hr
51	Mesa, AZ	$98,600	$47/hr
52	Chicago, IL	$98,300	$47/hr
53	Austin, TX	$98,300	$47/hr
54	Frisco, TX	$98,300	$47/hr
55	Tucson, AZ	$97,800	$47/hr
56	Glendale, AZ	$97,800	$47/hr
57	Spokane, WA	$97,800	$47/hr
58	Chandler, AZ	$97,700	$47/hr
59	Memphis, TN	$97,300	$47/hr
60	Pittsburgh, PA	$97,200	$47/hr
61	Tallahassee, FL	$97,200	$47/hr
62	Birmingham, AL	$96,600	$46/hr
63	Milwaukee, WI	$96,500	$46/hr
64	Albuquerque, NM	$96,500	$46/hr
65	Atlanta, GA	$96,300	$46/hr
66	Reno, NV	$96,300	$46/hr
67	Charleston, SC	$96,300	$46/hr
68	San Antonio, TX	$95,700	$46/hr
69	Grand Rapids, MI	$95,700	$46/hr
70	Detroit, MI	$95,100	$46/hr
71	Cincinnati, OH	$95,100	$46/hr
72	Lexington, KY	$95,100	$46/hr
73	Buffalo, NY	$95,100	$46/hr
74	Greensboro, NC	$95,100	$46/hr
75	Knoxville, TN	$95,100	$46/hr
76	Virginia Beach, VA	$95,000	$46/hr
77	Chesapeake, VA	$95,000	$46/hr
78	North Las Vegas, NV	$95,000	$46/hr
79	Dallas, TX	$94,300	$45/hr
80	El Paso, TX	$94,300	$45/hr
81	Cleveland, OH	$94,300	$45/hr
82	Bakersfield, CA	$94,300	$45/hr
83	Indianapolis, IN	$93,700	$45/hr
84	Louisville, KY	$93,700	$45/hr
85	Norfolk, VA	$93,700	$45/hr
86	Charlotte, NC	$93,000	$45/hr
87	Fort Worth, TX	$92,300	$44/hr
88	Garland, TX	$92,300	$44/hr
89	Toledo, OH	$92,200	$44/hr
90	Lubbock, TX	$92,200	$44/hr
91	Arlington, TX	$91,700	$44/hr
92	Wichita, KS	$90,800	$44/hr
93	Fort Wayne, IN	$90,800	$44/hr
94	Mobile, AL	$90,800	$44/hr
95	Columbus, OH	$89,700	$43/hr
96	Kansas City, MO	$89,700	$43/hr
97	Corpus Christi, TX	$89,700	$43/hr
98	Omaha, NE	$88,400	$43/hr
99	Oklahoma City, OK	$87,700	$42/hr
100	Lincoln, NE	$87,700	$42/hr

Does location actually decide Occupational Therapist pay?

Occupational Therapist work is rarely remote, so the metro you choose still largely determines what you earn. Pay ranges from $87,700 in Lincoln to $132,400 in San Francisco — a spread of 51%.

Licensing adds friction the ranking does not show. Occupational Therapist requires State license via NBCOT certification exam, and licenses are issued state by state. Moving for a higher salary can mean re-credentialing, which takes time and sometimes additional exams — check reciprocity with the destination board before treating a pay gap as attainable.

Highest-paying is not the same as best-off

The nominal ranking and the useful ranking are not the same. In San Francisco, $132,400 against $3,000/month rent leaves roughly $96,400 a year after housing. In Lincoln, $87,700 against $950 leaves about $76,300. The top still wins after rent, but by $20,100 rather than the $44,700 the headline suggests.

Why these metros and not others

What puts a metro near the top here is employer density, not price level. San Francisco (Salesforce, Google); Honolulu (U.S. Pacific Fleet/Joint Base Pearl Harbor-Hickam, Queen's Health Systems); Oakland (Kaiser Permanente (HQ), Port of Oakland). Where healthcare employers compete for the same candidates, offers rise above what the local cost of living alone would predict.

Salaries are modelled from BLS national medians adjusted for local price level at a wage elasticity below 1 — pay rises with local costs but not proportionally. See our methodology.

Frequently Asked Questions

Which city pays Occupational Therapists the most?▾

San Francisco, at roughly $132,400. Rent there averages $3,000 a month for a one-bedroom, so about $36,000 of that salary goes to housing before anything else. The metros near the top combine high local costs with concentrated healthcare employment — the second part is what actually lifts pay above the local baseline.

Does a bigger salary here mean more money left over?▾

Usually not. The cost-adjusted column matters more than the nominal one — a Occupational Therapist earning less in a cheaper metro often keeps more. Rank by what remains after housing and tax, not by gross.

Can a Occupational Therapist work remotely from a cheaper city?▾

Largely no — the work is rarely remote. For this occupation the metro you live in and the metro that pays you are the same, which makes the ranking above a genuine relocation decision rather than something you can arbitrage.

Do I need a new license to work as a Occupational Therapist in another state?▾

Often yes. Occupational Therapist requires State license via NBCOT certification exam, issued state by state. Some states have reciprocity agreements that make the transfer routine; others require re-examination. Confirm with the destination board before treating a higher-paying metro as reachable.