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How to Make the Most Money as a New Grad Occupational Therapist

by Dominic Lloyd-Randolfi, OTD, OTR/L


Well, this isn’t groundbreaking news: education is expensive and occupational therapy school is no different. With undergraduate loans and living expenses, chances are you are going to have some serious student debt. But there is a way to make money as a new grad occupational therapist — it just takes some planning!

Sometimes in healthcare we have to sacrifice high income and our lifestyles for our dream job and feeling valued. We all want to make a difference in helping others. No one chooses to be an occupational therapist for the money. However, there’s no shame in wanting a high salary to pay off those loans and to meet other goals such as buying a house or starting a family. Our goal is to help new grad occupational therapists maximize their salaries and to receive payment for what they are worth.

Looking for a job? Download the Ultimate Guide To Jobs After Occupational Therapy School! 👇🏻

Our favorite tool is It’s an open-source project where you can see REAL salaries and compare based on region, experience, and setting. Don't forget to check out Kate Boyd's article on OT salary negotiation! There's definitely ways to make money as a new grad occupational therapist, if you go about it the right way.

Everyone has their own path to high income and financial freedom. If you are set on working in outpatient pediatrics, your best path may be working multiple moderately paying jobs. Sounds exhausting? Maybe you are a better fit for working one job in a higher paying setting (though it may not be as “glamorous” or your dream job). A less fun option does exist too. You can always live beneath your means and save your hard-earned cash. Either way, this article will give you the tools to financial success!

In this article, you will learn about

  • The highest paying settings
  • How to get bonuses and paid overtime
  • Travel therapy and where the high paying locations are
  • How to specialize
  • How to save and invest

Work in a SNF or Home Health

These are some of the highest paid settings for occupational therapists.

Home health can be lucrative, but make sure to strategize so you aren’t wasting time commuting all day. If this is your first OT job out of school, beware that getting decent mentoring will be a challenge. Get creative and seek out OT friends with whom you can share ideas and successes, because driving around town all day can be lonely.

Skilled Nursing Facilities are a popular choice for new grads. This setting is not always the best for honing your skills, and the productivity standards often make it frustrating. However, you can easily pair this with a PRN job that pays very well.

Make sure your financial needs are balanced well with your personal and professional growth. Choosing the right setting as a new grad can be difficult when you have such limited exposure to all the various jobs that an OT can work.

What is important to you? There are many pros and cons to working in HH and SNF.

Work in an environment that offers bonuses/incentives

It may not be for everyone, but some people thrive in busy, fast-paced environments. It WILL be stressful, but you can learn a lot from the sheer volume of patients. This is for you if you can maintain your sanity and your ethics. Though, the caveat is, you don’t want to work for a private company that ONLY reimburses for productivity.

During an interview for your OT job, feel free to ask if there are bonuses or profit sharing as you gain clinical skills and take continuing education.

Outpatient pediatrics and orthopedics are probably the settings most likely to offer incentives such as bonuses and profit sharing. If you are able to help the company grow by being productive and taking on initiatives, they will reward you.

Work in a place that offers overtime pay

For the settings mentioned above, it’s very rare that small, private companies will offer you overtime pay (it actually tends to be the opposite). Very small and private clinics are known for paying salary and then having you stay late with patients and paperwork.

Other side of the coin (pun intended), bigger companies and hospitals may pay you hourly and with that comes OTP, but it’s often frowned upon to work more than your 40 hours a week and you may get a nastygram from payroll. Lots of hospitals are understaffed, so be sure and take the opportunity of OTP if it’s there. Better yet, specialize in an area that makes you more desirable and in demand.

Work weekends

As I mentioned above, many facilities are understaffed and this staffing issue is magnified on the weekends! It’s not uncommon for OTs to be running around like a chicken with their head cut off on any given Saturday or Sunday.

Many places have set wages for new grads. If you offer to work weekends, HR tends to have more wiggle room with the budget and incentives since they are so hard to staff. Don’t be shy about asking for increased pay. Sometimes these places want (and need) patients to be seen.

Sign up to do travel therapy

Traveling as an occupational therapist is the ideal situation for a new grad OT. Not only is it the highest paying setting out there, but they also provide you with a living stipend, money for food, and may help with relocation costs. If you’re relatively young, why not? You’ve already moved away for school so it can be a great experience for a couple of years.

Most travel companies offer a generous traveling stipend or they will find corporate housing for you. While the latter is less stressful, I recommend taking the stipend. With this, you can find your own (aka cheaper) housing on Craigslist or AirBNB and pocket the money you save! Some therapists take travel contracts in areas with a low cost of living or in areas near friends or family where they can live with reduced rent.

Of course, there is a downside to traveling. Your mentorship is not going to be as robust and you will be expected to take on a full caseload and see all sorts of conditions and diagnoses. You’ll also have to learn new documentation systems and as soon as you get comfortable, it will be time to move on to the next facility.

Move to a rural location

Oftentimes, the larger cities are more popular (and have more OT schools) which can result in an OT-saturated market. Consider moving to a rural location! It’s not guaranteed, but sometimes these locations have high salaries because they have a hard time filling the position.

The secret is in the cheap cost of living and offers a chance for you to save your hard-earned cash. Similar to traveling, it’s an adventure and doesn’t have to be permanent. Try this a couple of years to make a serious dent in your loans. Who knows, you may actually love it!

Avoid salaried positions

Similar to number 2, salaried can often mean working over 40 hours a week. You are paid a set amount of money to show up during the week to complete your job. It’s a recipe for burnout and the possibility of staying in the office late really hampers your ability to work a second gig, have a family, or go to the gym.

A long time ago, OTs were dependent on full time jobs for health care. But now with the Affordable Care Act, you HAVE to have health insurance. The online Marketplace makes this easy. With with as an option, you now have the freedom to explore areas that interest you the most and you can shop around for the highest hourly rate.


If you really focus your time and energy (and passion) you can specialize in an aspect of occupational therapy. Wounds? Hands? Sensory Integration? Low Vision? Lymphedema?

With these extra skills you will be able to provide a service and increase the business and capacity/diversity of your work environment. With such a special skill that brings in revenue, your workplace will reward you. It also may afford you the opportunity to open your own clinic down the road.

Live like a student

It sounds silly, but listen up. Be frugal and cut costs where necessary. Maybe only go to Target once a month or only pay for one streaming service. Give yourself challenges to not eat out (pack a lunch), or stop buying coffee.

A penny saved is a penny earned. And every penny counts! Rent (other than student loans) is going to be your biggest expense. Try living with a roommate for a while to save some cash and keep living like you are still in grad school. Avoid any extravagant purchases and keep it simple. The last thing you want now is credit card debt or a car loan to pay on every month.

Cash-based practice

Definitely more common in the physical therapy world, cash-based practice is taking over the rehab industry. It certainly has potential! Cash pay could be used in the outpatient hands setting. It could also really make a difference in pediatrics. We often work with families that do not have insurance, or their insurance does not cover occupational therapy services.

Now all you have to do is charge a simple, flat rate fee for every time they walk into the door. It creates less stress on your end because you don’t have to deal with insurance companies and low reimbursement rates. You also aren’t limit in your treatment and documentation (think sensory integration) and can now provide services without worrying if they will be reimbursed or not.

Invest, invest, invest

The easiest way to get rich is to slowly let your money work for you. Always invest enough in your employer's benefits to receive a matching contribution. It’s free money and stupid not too.

You can also check out an investment plan outside of work. Most people consider either an IRA or Roth IRA because of the various tax breaks. You can purchase these from various servicers. Be sure an talk to a Certified Personal Accountant on what is most beneficial for you and your particular situation.

Acorns is a cool app where you link up your bank account and your “spare change” is invested passively for you. So, if you spend $2.50 on a coffee, $.50 is rounded up and put in an account for you. With a referral link, they even given you a free $5 to get your feet wet with.

Nothing will set you up for success down the road like saving now.

Finally . . .

Be patient: the biggest factor for reimbursement is years of experience. It is certainly possible to have a comfortable lifestyle as an occupational therapist. Just be sure to have a healthy dose of reality and don’t expect top dollar as a new grad. You’ll get there eventually, so sit back and relax and enjoy that you get paid to help others be as independent as possible in their everyday activities.

Compare student loan refinancing rates 💰
Did you know that the average Occupational Therapist has $190,000 of student debt?! Paying off that debt requires smart budgeting and a lot of discipline. Many of the therapists in our community have also chosen to refinance their loans to lower the interest rates and/or reduce monthly payments. If you're looking to refinance, we heartily recommend that you check out Credible. In a nutshell, Credible is a free service that lets you compare prequalified student loan refinancing rates from up to 10 lenders without affecting your credit score. Click here to compare rates

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