Occupational Therapist Salary in Texas 2026,
$106,140 Median | BLS Data by City

Texas occupational therapists earn a median $106,140 a year, $51.03 an hour, per BLS OEWS May 2025, with the middle half between $85,810 and $127,830 and a full range of $76,350 to $135,200. That is 5.8% above the $100,330 national median, and Texas takes no income tax out of it.

Austin-Round Rock-San Marcos at $122,050, well clear of Longview at $112,760, Odessa at $109,220, San Antonio-New Braunfels at $107,650 and Dallas-Fort Worth-Arlington at $106,110. Austin's premium reflects heavy paediatric and school-district demand against a high cost of living; Longview and Odessa pay above the state median for the opposite reason, as smaller markets bidding to fill posts.

The Texas Board of Occupational Therapy Examiners, which sits inside the Executive Council of Physical Therapy and Occupational Therapy Examiners — an administrative structure shared with physical therapy that only a few states use. Licensure requires an accredited occupational therapy programme, NBCOT certification and the Texas jurisprudence requirement; therapists licensed elsewhere apply for Texas licensure by endorsement through the same board.

No. Texas levies no personal income tax and no local income tax, so a therapist at the median of $106,140 keeps the entire amount apart from federal tax. In a profession where salaries vary comparatively little between states, that treatment is frequently the largest real difference between offers — and it applies equally to contract and per-visit income.

Home health with per-visit or case-rate pay, contract and travel assignments, and certified hand therapy practice. Home health in Texas pays by visit rather than by salary, which lets a productive therapist exceed the $127,830 seventy-fifth percentile; hand therapy certification is the clearest clinical specialisation premium; and Austin-Round Rock-San Marcos at $122,050 pays the highest metro rate in the state for salaried practice.

Demand outrunning a below-average supply. Texas's location quotient of 0.91 across about 13,400 therapists means the state employs fewer occupational therapists per worker than the country does, while its demand drivers — one of the largest school-age populations in the United States requiring school-based services, a rapidly ageing cohort in East and South Texas, and a growing inpatient rehabilitation sector — keep expanding. Fewer therapists against rising demand produces the $106,140 median and Austin's $122,050.

A large part of Texas occupational therapy is school-based, and school-district contracts are typically nine- or ten-month appointments. Annualised wage figures for those roles are not directly comparable to twelve-month clinical salaries, and the $76,350 tenth percentile partly reflects that structure rather than low hourly rates. Home-health therapists paid per visit, at the other end, can exceed the published band in a good year and fall below it in a poor one.

Setting, productivity and specialisation. Skilled nursing and home health pay differently from hospital and school-based practice, and home health in Texas is generally per-visit, which rewards efficiency directly. Productivity expectations in outpatient and skilled-nursing settings attach bonuses to caseload volume. And specialisation — certified hand therapy above all, plus paediatric and neurological practice — is what larger Texas systems use to justify a differential from the $106,140 median toward the $127,830 seventy-fifth percentile, with the state taxing none of it.