When ADVANCE conducted its last salary survey in 2003, occupational therapy salaries were recovering nicely from the rehab recession of 1998-2000, with an average of $51,352 for OTs and $35,635 for OTAs. We're happy to report that in the last six years, salaries have continued to increase. Among those who responded to our survey, pay is up more than 25 percent for both levels of the profession-to $65,190 for full-time OTs and $45,044 for full-time OTAs.

Hourly rates for OTs who work full time averaged $37.23; rates for OTAs averaged $24.93. This is the first time ADVANCE has collected hourly pay data; according to our survey results, nearly half of OTs (48 percent) and most OTAs (82 percent) who responded are paid on an hourly basis. For OTs, we provide both salary and hourly figures where there are more than 10 respondents. Since OTAs are paid primarily hourly, we use hourly rates for our analysis of OTA pay. The figures provided in this story represent those practitioners working full time unless otherwise indicated.

So far the global economic crisis does not appear to be affecting the profession on any kind of large scale. Seventy-six percent of respondents reported no change in job status in the last 12 months (our survey data was collected from 2,023 respondents from Dec. 2008 through March 2009). Fifteen percent changed jobs, and just shy of one percent became self-employed. Only 7 people reported losing their jobs and being unemployed, and 4 left the field of OT.

Salaries by State

While the national average is up considerably from 2003 among our respondents, rates vary significantly by state. North Carolina came in highest at $83,087, and averages in California, Florida, Maryland, Indiana and New Jersey all topped $70,000. Salaries in many states remain below average, however. Wisconsin ranked lowest, at $55,982; Several other states, with fewer than 10 respondents, reported salaries below $60,000 (See Table 1 for salaries by state).

By hourly rate, New York OTs ranked highest at $47.11/hour, followed by Arizona ($44.53) and New Jersey ($43.70). Lowest hourly rates were found in Virginia at $32.81/hour, but again, several states with fewer than 10 respondents cite rates under $30 an hour.

For OTAs the highest pay was in Texas at $29.26/hour, with California and Florida following. Lowest rates were in Wisconsin at $19.94/hour; however, many other states in the survey had fewer than 10 OTA respondents.

Settings and Employers

The most popular settings for practitioners remain skilled nursing facilities, with 25 percent of all respondents working there, and schools, with 23 percent. In 2003, the two were switched, with 20 percent in schools and 18 percent in SNFs. Medicare changes to quality of life standards in nursing homes may be helping to fuel this increase.

OTs and OTAs very often are not actually employed directly by the places where they work. Forty-eight percent of the therapists working in SNFs, for instance, were employed by rehab companies or staffing agencies, compared to only 38 percent who worked directly for their facilities. In fact, rehab staffing companies employed 19 percent of all our respondents.

Hospitals, however, still employed 24 percent. These people worked in acute care, inpatient rehab, hospital-based ­outpatient rehab units and off-site outpatient clinics.

In schools, only 10 percent of therapists were employed by agencies; 61 percent were employed directly by the schools/districts; another 14 percent were paid by government agencies (see Table 2 for salaries by employer).

Among those occupational therapists who responded to our survey, the most lucrative setting by salary was skilled nursing facilities ($74,828 or $35.59/hour), followed by hand clinics ($70,958 or $35.15/hour) and hospital outpatient clinics ($70,409 or $36.15/hour). SNF salaries were highest in 2003 as well, with an average then of $52,776. And, as in 2003, OT respondents in schools are still making below-average pay, at $60,012.

By hourly rate, pay for therapists who work in clients' homes ($48.88) and for those in schools ($45.93) jumps, indicating that some of these respondents may be working as true independent contractors or in consultation models.

SNFs themselves and staffing agencies stand about equal as employers. SNFs came in at $75,257 annually or $35.38/hour; rehab/staffing companies at $74,773 or $36.03/hour.

Not surprisingly, non-profit corporations came in as the lowest-paying employers at $57,612 or $32.60/hour.

Again, the survey results show a spike in hourly pay for OTs employed by agencies ($50.92) and in schools ($46.60), reflecting, again, potentially higher rates for those operating under a consultant model.

By setting, occupational therapy assistants who answered our survey are making the most in schools with $26.29, followed right behind by SNFs ($26.18). The lowest-paying settings for OTAs are hospital settings; those in acute care report earning $19.44/hour, while those working in both inpatient and outpatient hospital settings make $20.87 (see Table 3 for salaries by setting).

Specialty Certifications and Education

How are specialty certifications affecting employment and salary?

Only 19 therapists (just under 1 percent) said that not having a cert has kept them from getting a job. Another 14 said it has kept them from getting reimbursed. Of the 79 therapists who have gotten promoted in the last 12 months, 37 have specialty certifications.

The most popular certification among our survey respondents was NDT (88 therapists), followed by certification in the Sensory Integration and Praxis Tests (74 therapists). More than 7 percent of therapists report being certified through their states to use physical agent modalities.

The average salary for OTs with specialty certification is $69,309 or $39.78/hour; for OTAs the hourly rate is $25.37, indicating that specialty certifications don't give OTAs the same pay bump. However, few OTAs with certifications responded to the survey.

Among OTs working full time who responded to our survey, NDT-trained therapists had the highest average salaries at $81,442 or $44.72 an hour; NDT-certified OTAs make $25.28 an hour. Next, CHTs are making $78,956 a year; however, those who reported hourly rates were at only $36.72, some 51 cents an hour below the national average.

OTs with industrial rehab credentials, including certified work capacity evaluators (CWCEs) and those certified to perform functional capacity evaluations (FCEs) are earning $71,917 or $38.69/hour.

Relatively few therapists have attained AOTA's fairly new credentials. Only 8 respondents have board certifications and 15 have specialty certifications. The OTs with board certifications earned an average of $57.20 an hour; however, OTs with AOTA specialty certs earned only slightly above the national average with $42.19 an hour. OTAs with AOTA's specialty certs earned $28.45. However, since the number of respondents with these credentials are so low, they may not reflect the broader clinical picture.

When it comes to education, the numbers show some interesting trends. OTs with entry-level master's degrees are making the least, at $59,431. OTs with bachelors degrees ($67,955) make only slightly more than those with post-professional master's degrees ($67,751), while OTDs came in at $69,133. A PhD will significantly up your earnings to nearly $75K.

Only 21 OTDs responded to the survey. One-third work in skilled nursing or assisted living, and another 15 percent work in schools; none reported working outside the field of OT.

Demographics

According to this survey, OT salaries trend upward for the first 10 years in the profession, then level off. OTA salaries seem to level off after five years in the profession.

As expected, an OT will earn more the longer she stays at a job; for example, if she starts at $62,566, in 10 years she may be earning $70,613. For OTAs, however, there is a less significant increase over time, indicating that OTAs might be more likely to earn more by switching jobs than by waiting for raises at current positions.

Overall, OT practitioners are still mostly Caucasian (85 percent); however, that number drops to 81 percent among therapists in the profession five years or less, indicating that more minorities may be entering the profession recently.

Only 4.4 percent of respondent OTs were African-American, but on average they were earning $70,330; more than 37 percent report working in skilled nursing, which is the highest-paying setting.

Nearly 10 percent of our OT respondents this year were men, who still earn more than women. In our 2003 survey, men were earning $6,500 a year more than women. In 2009 that gap is unchanged, with men earning an average $70,232 and women earning $64,656. For OTAs, however, the gap seems to have disappeared: female OTAs reported making $24.98 an hour, while males made 52 cents less, at $24.46. The OTA sample, however, was much smaller than the OT sample in the survey.

As in 2003, we'll make these survey results available on our Web site at www.advanceweb.com/OT.

Jill Glomstad is ADVANCE managing editor.