One BLS page, two very different paychecks
BLS tracks occupational therapy assistants under SOC code 31-2011, but publishes that data on a single Occupational Outlook Handbook page shared with a second, related occupation: occupational therapy aides (31-2012). The two titles sound close enough to blur together, and BLS's own combined header stat for the page, $70,800 a year, blends them into one number. Split apart, the gap is large: assistants earned a median of $72,300 in May 2025, while aides earned $39,160, a difference of $33,140. The assistant tenth-percentile boundary, $51,490, exceeds the $39,160 aide median. Assistants in the lowest tenth earn below that boundary, so the table does not show that all of them earn more than a typical aide.
The pay gap tracks a real difference in what the job requires. Per BLS, occupational therapy assistants typically need an associate's degree from an accredited occupational therapy assistant program and usually a state-issued license, working directly with clients on therapeutic exercises and skill-building under an occupational therapist's supervision. Occupational therapy aides typically need only a high school diploma or its equivalent and learn on the job, handling setup, scheduling, and other support tasks rather than delivering therapy themselves. BLS describes licensing requirements; state boards, not BLS, issue occupational licenses.
Pay by industry, and the associate's-degree ceiling next to a master's-degree role on this site
BLS breaks out May 2025 wages for occupational therapy assistants across five industry categories. Home healthcare services paid the highest median at $77,310, just ahead of nursing care facilities (skilled nursing facilities) at $76,780. Offices of physical, occupational and speech therapists, and audiologists, the outpatient-clinic setting, paid $70,740, followed by hospitals at $67,020. Educational services, meaning school-based work, paid the least of the five tracked categories at $60,920, a $16,390 gap between the highest- and lowest-paying settings BLS lists here.
Against occupational therapists, the credentialed role assistants work under, the pay gap is substantial: BLS puts the OT median at $100,330 (also from May 2025), about $28,030 above it. That gap lines up with a real difference in schooling, a master's degree for OTs versus an associate's degree for assistants, roughly two additional years of graduate coursework. Against dental hygienists, another allied-health role this site tracks, the comparison cuts the other way: BLS reports a $98,100 median for dental hygienists, $25,800 above occupational therapy assistants, even though BLS lists an associate's degree as the typical entry-level education for both occupations, a fact this site's dental hygienist page does not itself spell out but that BLS states directly on its own dental hygienist handbook page. BLS does not explain on either page why two associate's-degree fields land so far apart in pay. A master's-degree field with a required residency also lands below the hygienist figure, as this site's orthotist and prosthetist salary guide shows.
Licensing and the COTA credential
Per BLS, occupational therapy assistants typically complete an associate's degree from an accredited program, generally about two years of full-time study, though some bachelor's degree programs also exist. Licensure then usually requires that accredited program, a fieldwork component, and passing an exam; BLS notes some states add further requirements, such as a background check, and points readers to CareerOneStop for state-specific licensing board details rather than listing all fifty states' rules itself. Passing the exam is also what lets a graduate use the title Certified Occupational Therapy Assistant, or COTA, per BLS.
Occupational therapy aides, by contrast, are not described by BLS as needing a license at all; their entry path is a high school diploma or equivalent plus on-the-job training, with no accredited program, fieldwork, or exam involved.
Job outlook, and how it compares to the aide role sharing this BLS page
BLS projects 21% employment growth for occupational therapy assistants from 2025 to 2035, classified as much faster than the roughly 3% average across all occupations, adding an estimated 11,200 jobs to a 2025 workforce of 52,200. That rate runs well ahead of the 4% growth BLS projects for occupational therapy aides over the same decade, the lower-paid role on the same combined OOH page, and also outpaces the 20% BLS projects for the two occupations blended together. About 8,600 openings a year, on average, are projected for occupational therapy assistants and aides combined; BLS does not split that annual-openings figure between the two roles the way it splits pay and employment counts.
BLS attributes the broader demand for occupational therapy services to the healthcare needs of an aging population, a driver it also cites for occupational therapists themselves, whose own 15% growth projection trails the assistant role's 21% figure. BLS does not attribute the difference between the two cycles' growth rates to a specific cause on either page.