Occupational Therapist.
Houston.
$83,000
median salary, 3% below the national average
$68,000 to $101,000. Updated for 2026.
The numbers.
Everything you need to negotiate with confidence.
A Occupational Therapist in Houston earns a median of $83,000 in 2026. That is 3% below the national average. The range runs from $68,000 to $101,000, and where you land depends on your experience, your skills, and how well you negotiate. Practice setting is the primary salary driver, with acute care hospitals and home health paying above outpatient and school-based roles.
Salary range
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How Houston compares
Houston, TX
$83,000
Cost of living: 3% below average
National Average
$86,000
Houston is $3,000 below
What you should know
Here is what the Occupational Therapist market actually looks like in Houston. Houston's economy is deeply rooted in energy, with a growing presence in healthcare, aerospace, and technology. The Texas Medical Center is the world's largest, driving massive demand for clinical and research roles. Houston's low cost of living and no state income tax make it an attractive destination for professionals seeking strong purchasing power. 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 Houston, cost of living sits near the national average, so the numbers you see are roughly what you keep.
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: texas has no state income tax, giving Houston workers strong take home pay. The city's overall cost of living is below the national average, further stretching your salary. When someone quotes you $83,000, ask what the total package looks like. The gap between base and total comp is where real money hides.
On negotiation: Emphasize industry specialization in energy or healthcare. Houston employers pay significant premiums for domain expertise in these sectors over generalist candidates. The range for Occupational Therapists in Houston runs from $68,000 to $101,000. That is not a narrow window. Where you land inside it depends almost entirely on whether you negotiate and how well you prepare.
Top industries in Houston
Negotiating in Houston
Emphasize industry specialization in energy or healthcare. Houston employers pay significant premiums for domain expertise in these sectors over generalist candidates.