Occupational Therapist Salary in Maryland 2026,
$106,980 Median | BLS Data by City

The published Maryland figure is $106,980 a year, or $51.43 an hour, per BLS OEWS May 2025 — 6.6% above the national median of $100,330 — across a band from $76,650 at the 10th percentile to $132,300 at the 90th. With one accredited entry route and a state licence, the band reflects setting, specialisation and leadership rather than differing qualifications.

Lexington Park at $106,320, then Baltimore-Columbia-Towson $105,490, Salisbury $104,400 and Hagerstown-Martinsburg $102,840 — under four thousand dollars across the whole table. Maryland's Washington-area counties are reported within the Washington-Arlington-Alexandria metropolitan area and do not appear, which removes the state's largest suburban market from the comparison.

Yes. The Maryland Board of Occupational Therapy Practice licenses both occupational therapists and occupational therapy assistants, requiring graduation from an ACOTE-accredited programme, passage of the NBCOT certification examination and application to the board. The licence is Maryland-specific rather than granted by privilege from another state, so relocating therapists apply directly. The board also sets the supervision rules governing what a therapist may delegate to an assistant.

Home health and skilled nursing generally sit above school-based and outpatient practice, with travel and contract work above both — that progression accounts for most of the distance from the $87,650 twenty-fifth percentile to the $123,700 seventy-fifth. School-based practice offers a school-year calendar and predictable hours at lower annual pay. Hand therapy and assistive technology specialisation raise pay within any setting, and rehabilitation management is the main non-clinical route toward the $132,300 ninetieth percentile.

Because the profession is uniform in a way most occupations are not. One accredited educational route, one state licence, one certification, and largely standardised practice settings across the state mean there is little for geography to differentiate. Employers compete for the same nationally certified therapists on broadly similar terms. What varies instead is setting and productivity model — and in Maryland, the county income tax, which at 2.25% to 3.2% can be worth a meaningful fraction of the entire metro pay spread.

Because it determines the productivity model. An occupational therapist evaluates, sets goals and manages a caseload; an occupational therapy assistant delivers much of the treatment under supervision the Maryland board defines. How much can be delegated, and under what level of oversight, decides how many patients a single therapist can be responsible for — which in turn determines what a setting can afford to pay. That is why the board's supervision rules, which look like an administrative detail, sit underneath the economics of the whole profession in this state.

Productivity-based pay and part-time practice. A substantial share of Maryland occupational therapy — particularly home health and contract work — is compensated per visit or on productivity targets rather than as straight salary, so two therapists at the same reported annual figure may carry very different caseloads. School-based practice runs on a school-year calendar that annualises awkwardly. And with the Washington-area counties reported separately, the four-metro table describes a partial and unrepresentative slice of Maryland practice.

Setting first — home health and skilled nursing above school and outpatient practice, with travel and contract work above both. Then specialisation, since hand therapy, neurological rehabilitation, paediatrics and assistive technology are separately valued. Then productivity structure, given how much Maryland practice is paid on visit-based models. Then leadership, with rehabilitation management the main non-clinical progression. And then county of residence, which through Maryland's local income tax alters take-home by a measurable amount.