Occupational Therapist.
Des Moines.
$73,000
median salary, 15% below the national average
$60,000 to $89,000. Last updated April 2026.
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Data points to own the conversation.
Occupational Therapist pay in Des Moines ranges from $60,000 to $89,000 in 2026. The median is $73,000, 15% below the national average. Des Moines is a major insurance and financial services hub, home to Principal Financial, EMC Insurance, and a growing fintech community. Every dollar in that range is negotiable if you come prepared.
Salary range
Where do you fall?
Salary by experience
The gap between entry and lead level is typically $66,000. Where you land depends on years of experience and what you bring to the table.
Entry (0-2 yrs)
$47,000
to $58,000
Mid (3-5 yrs)
$62,000
to $77,000
Senior (6-9 yrs)
$80,000
to $95,000
Lead (10+ yrs)
$91,000
to $113,000
Salary trend
+4% YoYTotal compensation
Base salary is not the full picture. Equity, bonus, and signing can add $19,000 to the total package.
Base
$73,000
Equity
$11,000
Bonus
$7,000
Signing
$1,000
Estimated total: $92,000
How Des Moines compares
Des Moines, IA
$73,000
Cost of living: 14% below average
National Average
$86,000
Des Moines is $13,000 below
Occupational Therapist salary by city
Salary by role in Des Moines
What you should know
Before you negotiate a Occupational Therapist offer in Des Moines, understand the terrain. Des Moines is a major insurance and financial services hub, home to Principal Financial, EMC Insurance, and a growing fintech community. The metro's extremely low cost of living and strong job market make it one of the best value cities for finance professionals. Tech employment is growing as insurtech companies expand. 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 Des Moines, your dollars stretch further. Cost of living runs 14% 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: iowa has a flat 3.8% state income tax. Des Moines has no city income tax. The low tax rate and affordable housing create strong purchasing power. When someone quotes you $73,000, ask what the total package looks like. The gap between base and total comp is where real money hides.
On negotiation: Benchmark against national insurance industry pay scales. Des Moines insurance employers must compete with remote offers from larger metros and will often match. The range for Occupational Therapists in Des Moines runs from $60,000 to $89,000. 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
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Common questions.
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