Healthcare · State Rankings

Best US States for Occupational Therapists

All 50 states + DC ranked by Occupational Therapist salary. State tax structure noted for take-home math.

Top 10 states by salary
#StateEstimated salaryCost mult.State tax
1California$118,8001.18×~5% effective
2Hawaii$116,6001.15×~5% effective
3Massachusetts$114,3001.12×~5% effective
4Maryland$111,3001.08×~5% effective
5New York$111,3001.15×~5% effective
6Alaska$109,8001.13×No state tax
7New Jersey$109,8001.13×~5% effective
8District of Columbia$108,3001.20×~5% effective
9Washington$107,8001.10×No state tax
10Nevada$106,9001.02×No state tax
All 51 states + DC, ranked
#StateSalaryAfter state tax (rough)
1California$118,800$87,140
2Hawaii$116,600$85,526
3Massachusetts$114,300$83,839
4Maryland$111,300$81,639
5New York$111,300$81,639
6Alaska$109,800$86,028
7New Jersey$109,800$80,538
8District of Columbia$108,300$79,438
9Washington$107,800$84,461
10Nevada$106,900$83,756
11Colorado$104,200$76,431
12Oregon$104,200$76,431
13Pennsylvania$103,200$75,697
14Connecticut$101,700$74,597
15Arizona$100,700$73,863
16Delaware$100,700$73,863
17Florida$100,700$78,898
18Minnesota$100,700$73,863
19Texas$98,600$77,253
20Utah$98,600$72,323
21New Hampshire$98,300$77,018
22Louisiana$98,100$71,956
23Rhode Island$97,000$71,150
24Virginia$97,000$71,150
25Alabama$96,600$70,856
26North Carolina$96,500$70,783
27Idaho$95,700$70,196
28Michigan$95,700$70,196
29Wisconsin$95,700$70,196
30New Mexico$95,100$69,756
31Tennessee$95,100$74,511
32Illinois$95,000$69,683
33Indiana$94,300$69,169
34Kansas$94,300$69,169
35Ohio$94,300$69,169
36Vermont$94,300$69,169
37Maine$93,000$68,216
38Kentucky$92,200$67,629
39Georgia$91,000$66,749
40Montana$90,300$66,235
41Wyoming$90,300$70,750
42North Dakota$89,700$65,795
43South Carolina$89,700$65,795
44Nebraska$89,000$65,282
45South Dakota$89,000$69,732
46Iowa$88,400$64,841
47Missouri$88,400$64,841
48Oklahoma$87,000$63,815
49Arkansas$85,700$62,861
50West Virginia$85,700$62,861
51Mississippi$84,400$61,907
After-state-tax estimate uses federal ~14% + FICA 7.65% + state ~5% (or 0% in no-tax states).

What moves with you and what does not

Because Occupational Therapist is a licensed occupation (State license via NBCOT certification exam), the pay differences between states persist in a way they would not otherwise. Workers cannot freely move to the highest-paying state, so the gap does not close. That is worth knowing both as a barrier and, once you hold the license, as protection.

Tax and what the numbers are worth

Income tax reshuffles this ranking. Alaska, Washington, Nevada appear in the top ten and levy no state income tax, so the gross figures understate take-home there by roughly 3–6% relative to a taxing state at the same salary. Against a high-tax state, that is worth several thousand dollars a year at this occupation's median of $95,000.

The offset is usually property tax. States without an income tax recover the revenue elsewhere, so the advantage is largest for renters and narrows considerably for homeowners. Run both if you plan to buy.

The spread from Mississippi ($84,400) to California ($118,800) is 41%. Cost of living explains most of it — a state paying 25% above the national median for this role usually costs proportionally more to live in, which is why cost-adjusted rankings look different from nominal ones.

Where the field is heading

Nationally, Occupational Therapist employment is projected to grow strongly — 14% through 2034, with roughly 10,200 openings a year counting replacements. Growth is rarely evenly distributed: states with the industry concentration driving that growth will feel it first, and the ranking above is a reasonable proxy for where.

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 state pays the most for Occupational Therapists?
Based on cost-of-living-adjusted estimates, California pays the most with an estimated median of $118,800/year for Occupational Therapists. High-cost states (CA, NY, MA, HI) tend to top the list because employers compensate for local cost of living.
Do no-state-tax states pay better effective?
Often yes after taxes. Alaska, Washington, Nevada, Florida, Texas have no state income tax. A 5% state tax savings on $100K = $5,000 more take-home. But verify cost of living too — Texas pays well and has no tax, but Houston/Austin housing has risen dramatically.
Why do some states pay so much more?
Three factors: (1) cost of living — coastal states cost 15-25% more, employers adjust pay; (2) employer concentration — CA dominates tech, NY finance, MA biotech; (3) regulatory environment — some states have higher unionization or licensing requirements that increase wages.
Are these salaries net or gross?
Gross — before federal income tax (~14% effective at this income), FICA (7.65%), state income tax (varies), and local taxes if applicable. Use our state-specific Paycheck Calculator for exact take-home in any state.
How does experience affect these numbers?
These are medians — entry-level often runs 25-35% below median, senior roles 40-60%+ above. A senior Occupational Therapist in California can easily exceed $178,200, while an entry-level role in a low-cost state might be $59,080.