Occupational Therapist.
Billings.
$79,000
median salary, 8% below the national average
$64,000 to $95,000. Last updated April 2026.
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Data points to own the conversation.
Here is what Occupational Therapists actually make in Billings: $64,000 at the 25th percentile, $79,000 at the median, and $95,000 at the 75th. That is 8% below the national average. Billings is Montana's largest city and economic hub, driven by energy, agriculture, and healthcare. The number on your offer letter will depend on what you bring and how you ask.
Salary range
Where do you fall?
Salary by experience
The gap between entry and lead level is typically $71,000. Where you land depends on years of experience and what you bring to the table.
Entry (0-2 yrs)
$51,000
to $63,000
Mid (3-5 yrs)
$67,000
to $83,000
Senior (6-9 yrs)
$87,000
to $103,000
Lead (10+ yrs)
$99,000
to $122,000
Salary trend
+5% YoYTotal compensation
Base salary is not the full picture. Equity, bonus, and signing can add $22,000 to the total package.
Base
$79,000
Equity
$12,000
Bonus
$8,000
Signing
$2,000
Estimated total: $101,000
How Billings compares
Billings, MT
$79,000
Cost of living: 11% below average
National Average
$86,000
Billings is $7,000 below
Occupational Therapist salary by city
Salary by role in Billings
What you should know
Before you negotiate a Occupational Therapist offer in Billings, understand the terrain. Billings is Montana's largest city and economic hub, driven by energy, agriculture, and healthcare. The city serves as a regional center for the Northern Plains. Remote work has brought a wave of tech professionals seeking Montana's quality of life, gradually diversifying the local job market. Practice setting is the primary salary driver, with acute care hospitals and home health paying above outpatient and school-based roles. Hand therapy certification commands a notable premium. States with higher Medicaid reimbursement rates and metropolitan areas with greater demand also push compensation upward.
New OTs start around $68,000 to $78,000 depending on setting. Mid-career OTs with specialty certifications reach $88,000 to $100,000. OT directors or program managers in hospital systems can earn $105,000 to $125,000 with administrative and clinical oversight responsibilities. In Billings, your dollars stretch further. Cost of living runs 11% below the national average, which means even a median salary buys a stronger lifestyle.
Base salary is not the full picture. OTs typically receive CEU allowances, student loan assistance programs, and comprehensive health benefits. Some employers offer productivity bonuses tied to billable units, adding $3,000 to $8,000 annually for high-performing therapists. And on the tax side: montana has a top income tax rate of 5.9% but no state sales tax. Billings has no city income tax. The no sales tax benefit helps offset the state income tax. When someone quotes you $79,000, ask what the total package looks like. The gap between base and total comp is where real money hides.
On negotiation: Negotiate remote work arrangements. Billings employers are increasingly open to remote and hybrid setups to attract talent from larger metros. The range for Occupational Therapists in Billings runs from $64,000 to $95,000. That is not a narrow window. Where you land inside it depends almost entirely on whether you negotiate and how well you prepare.
Sources: SEC filings, H-1B LCA (DOL), BLS OES, 50+ job posting platforms. COL: BEA Regional Price Parities (2025). Data verified by Justin Bartak, Founder & Chief AI Officer. Last verified April 8, 2026. Full methodology
Considering a related role?
- A Mechanical Engineer in Billings earns $80,000 (1% more)
- The highest-paying role in Billings is Chief AI Officer at $287,000
Common questions.
Occupational Therapist salary in other cities
Other salaries in Billings
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