Occupational Therapy Assistant Salary in Texas 2026,
$81,500 Median | BLS Data by City

Texas occupational therapy assistants earn a median $81,500 a year, $39.19 an hour, per BLS OEWS May 2025, with the middle half between $75,250 and $89,780 and a full range of $60,980 to $95,900. That is 12.7% above the $72,300 national median, and Texas takes no state income tax out of it.

Beaumont-Port Arthur at $82,610, then Austin-Round Rock-San Marcos at $81,500, Houston-Pasadena-The Woodlands at $81,340, Dallas-Fort Worth-Arlington at $81,170 and Texarkana at $79,720. Under three thousand dollars covers the whole table, so relocating within Texas for pay in this occupation is rarely worth the move.

Through the Texas Board of Occupational Therapy Examiners. You graduate from an ACOTE-accredited occupational therapy assistant programme, pass the NBCOT certification examination, and complete the Texas jurisprudence assessment before the Board issues the licence. Texas OTAs practise under the supervision of a licensed occupational therapist, with the required supervision level set by practice setting, and licences renew with continuing education.

Because of where the work is. Texas has an unusually large skilled nursing, inpatient rehabilitation and home health sector, and those settings employ and pay OTAs better than school-based or outpatient work does. A location quotient of 1.21 across about 5,610 OTAs means Texas is not short of them — the premium comes from the composition of demand, not scarcity.

Yes, straightforwardly at this income level. There is no state tax on the $81,500 median or on any part of the range, and no state return to file. The offset is property tax, which is high in Texas and is a homeowner's issue rather than a renter's. OTAs taking per-diem or contract work should focus on federal self-employment tax and quarterly estimates instead.

Because reimbursement sets the rate. OTA employment in Texas is concentrated in skilled nursing, rehabilitation and home health, all of which are paid through Medicare and Medicaid reimbursement systems that constrain what facilities can offer. The result is a $75,250 twenty-fifth percentile and an $89,780 seventy-fifth barely fifteen thousand apart, and a metro table where Austin, Houston and Dallas-Fort Worth differ by about fifteen hundred dollars.

Reimbursement risk sits behind it. Because so much Texas OTA employment depends on skilled nursing and home health payment rules, changes to therapy reimbursement have historically moved staffing and pay in this occupation quickly and sharply. The $81,500 median is accurate for the survey period; it is more exposed to policy change than a hospital-based allied health wage would be.

Setting, productivity and travel. Home health work in Texas is frequently paid per visit, so a full caseload with efficient routing earns more than a facility salary — that is the usual route to the $89,780 seventy-fifth percentile. Beyond that, the $95,900 ninetieth percentile generally means lead therapy assistant duty, rural coverage carrying mileage and travel premiums, or contract and per-diem work across several facilities, which trades benefits for rate.