Certified Occupational Therapy Assistants play a consistent role in rehabilitation care across the United States. Facilities depend on them to support occupational therapists, carry out daily treatment plans, and help patients regain functional skills. Because demand remains steady across hospitals, schools, and long-term care settings, many professionals want direct answers about COTA salary, hourly pay, and where strong job opportunities are available.
Across America, the job market for occupational therapy assistants continues to attract both new graduates and experienced clinicians. Pay often varies by location, setting, and experience level, which can make job comparisons difficult. Many therapists want clear salary data before applying, while others look for guidance from a trusted occupational therapist staffing agency that understands pay structures, schedules, and real hiring needs. This guide explains average salary ranges, location impacts, and practical ways to evaluate earnings with confidence.
COTA salary data provides a starting point for understanding pay across the country. While individual offers vary, national averages help establish realistic expectations before reviewing jobs or negotiating compensation.
The national average salary for a certified occupational therapy assistant is about $59,878 per year, which equals roughly $28.79 per hour. Recent reporting shows hourly pay commonly ranging from $29 to $32, depending on location and setting. According to national statistics, the median annual salary reported by the Bureau of Labor Statistics is $67,010, reflecting higher wages in metro markets and specialty care environments.
At the lower end of the range, some entry-level COTAs earn close to $42,000 per year, especially in rural or lower-cost states. At the higher end, experienced professionals in strong markets may earn $76,960 or more annually, with some travel roles exceeding $83,000.
Typical salary range overview
| Pay Level | Annual Salary | Hourly Rate |
|---|---|---|
| Lower end | $42,000 | $20 to $23 |
| National average | $59,878 | $28 to $29 |
| Median | $67,010 | $32 |
| Upper range | $76,960+ | $37+ |
Pay trends compare salaries over time show gradual upward movement driven by demand, staffing shortages, and reimbursement pressure across healthcare systems. Working with a therapy-focused staffing partner can help clarify what employers are currently offering and which roles align with your preferred schedule and location.
A certified occupational therapy assistant works under the supervision of licensed occupational therapists to help patients improve daily living skills after injury, illness, or developmental conditions. COTAs carry out treatment plans, document patient progress, and support education that promotes independence and functional ability.
Occupational therapy assistants work across a range of care settings, including hospitals, outpatient clinics, skilled nursing facilities, school systems, and home health programs. Job titles may vary, such as occupational therapy assistant COTA or certified occupational therapist assistant OTA, but responsibilities remain consistent under state practice guidelines.
Salary details vary depending on how the data is collected. Some sources rely on employer postings, while others use surveys submitted by therapists. This creates variation between averages, medians, and reported estimates.
Salary details lorem ipsum is sometimes used as placeholder text in internal templates or draft documents. Similar placeholder terms such as lorem ipsum, dummy text, simply dummy text, and industry’s standard dummy text originate from the printing and typesetting industry. These terms appear in formatting examples, not in real compensation research. Any salary document should replace placeholder content before publication.
Actual pay calculations depend on multiple factors:
When employers calculate pay, they often use the sum of base wages plus incentives. Median figures help reduce distortion caused by part-time or PRN roles. This explains why calculated averages may differ between sources using different data sets.
Location impacts earnings more than almost any other factor. Geography affects demand, reimbursement rates, and cost of living, all of which shape wages. States with some of the highest average salaries include California, Massachusetts, New York, and Illinois. California leads the country, with COTAs earning an average of $79,560 per year. Massachusetts and New York also remain strong due to dense healthcare systems and consistent demand.
Lower-paying states such as South Dakota and Wisconsin often report averages under $50,000. This does not always reflect job quality, but rather differences in living costs and reimbursement models. Individual cities can show large variations within the same state. Metropolitan areas often pay more than rural locations due to staffing competition. Examples of high-paying cities include:
In mid-sized markets such as Columbia and surrounding regions, pay often balances steady demand with lower living expenses. Many therapists prefer these locations for long-term stability rather than peak wages.
Experience level strongly influences earnings. Entry-level COTAs with less than one year of experience typically earn about $26.09 per hour, though offers may range from $44,000 to $60,000 annually, depending on location.
Mid-career professionals with two to four years of experience often earn between $61,000 and $63,000. Therapists with five or more years can command $63,000 to $88,000, especially in high-demand settings.
Skills that increase earning potential include:
Education also plays a role. While the role requires an associate degree, advanced certifications in pediatrics, hand therapy, or specialty populations can raise pay opportunities.
Employers structure pay based on care setting and operational needs. Hospitals often offer stable schedules and benefits, while skilled nursing facilities and home health settings may offer higher hourly rates due to workload intensity.
School-based positions usually provide predictable schedules but lower wages. Home health and SNF roles often pay more because of productivity demands and travel requirements.
Schedule type also matters:
Reimbursement structures shape how much facilities can offer. When reimbursement rates tighten, employers may limit raises even in strong job markets. This makes understanding market conditions essential when reviewing offers.
Active jobs change weekly based on census levels and coverage needs. Facilities often seek COTAs for short-term contracts, temp-to-perm roles, or permanent placement.
When reviewing job listings, therapists should confirm:
Employers value reliability, documentation accuracy, and communication skills. Therapists who demonstrate flexibility often receive faster placements and stronger pay offers. Flagstar Rehab supports both facilities and therapists by matching credentials, preferences, and availability efficiently through its occupational therapist staffing agency network.
Earning more money often comes from strategy rather than tenure alone. Negotiation plays a direct role in compensation, especially during the offer stages.
Helpful approaches include:
Working PRN can raise hourly pay, though hours may fluctuate. Changing employers also remains one of the most common ways to increase earnings. Many therapists see meaningful raises when switching facilities rather than waiting for incremental annual increases.
A clear plan helps guide decisions. Identify preferred locations, set minimum acceptable pay, track offers, and adjust strategy based on demand.
COTAs report an average job satisfaction rating of 3.36 out of 5. Many enjoy patient interaction and daily impact, even while facing workload pressure.
Burnout can occur due to documentation demands and productivity standards. Still, many therapists find long-term satisfaction through supportive teams, manageable caseloads, and predictable schedules. Career growth paths include lead COTA roles, specialty focus areas, or administrative coordination. Some advance into management or education-related positions with higher earnings over time.
COTA salary ranges reflect location, experience, and care setting more than any single factor. National averages provide guidance, but individual job offers depend on local demand and employer needs. Understanding data, pay structures, and negotiation options helps therapists make informed career decisions.
Flagstar Rehab partners with therapists and healthcare facilities across America to support long-term staffing success. Whether you are seeking better pay, stronger scheduling, or reliable coverage support, our team helps align goals on both sides. Contact Flagstar Rehabto explore current opportunities and staffing solutions that fit your needs.
COTAs earn the highest pay in states such as California, Massachusetts, Washington, and New Jersey. Large metropolitan areas and travel assignments often exceed national averages due to higher demand. Facilities in these regions typically offer stronger hourly rates to secure coverage.
A COTA carries out occupational therapy treatment plans under the supervision of an occupational therapist. Daily duties include assisting patients with functional activities, documenting progress, and supporting care goals. COTAs work in settings such as hospitals, schools, and rehabilitation facilities.
Stress levels depend on setting, workload, and productivity expectations. Some roles involve fast-paced environments, while others offer steady schedules and manageable caseloads. Many COTAs report satisfaction from consistent employment and patient interaction.
The average salary for an OTA ranges from about $59,000 to $67,000 per year nationwide. Hourly pay commonly falls between $28 and $32, depending on location and experience. Higher wages are often found in metropolitan areas and contract roles.