Best Metro Areas for Occupational Therapists in 2026: New York Leads as California Metros Top Pay

Across LaborCove’s top 10 metro areas for occupational therapists, there is a clear split between very high‑paying California markets and larger metro areas where employment counts are higher but salaries are closer to the national median. New York-Newark-Jersey City, NY-NJ ranks first overall with the largest employment count among these metros, while several California metros provide higher median pay but smaller employment totals. Because LaborCove rankings synthesize multiple metrics, the top‑ranked metro is not always the highest‑paying one. For example, San Jose-Sunnyvale-Santa Clara, CA and Vallejo, CA have higher median salaries than New York-Newark-Jersey City, NY-NJ, yet New York holds the #1 spot. Occupational therapists can use this mix of rankings, pay, and scale to identify which combination of factors best matches their own priorities, considering the national occupation context of a 13.8% projected employment growth rate.

At the national level, occupational therapists have a reported median annual salary of $100,330 in 2026, based on 162,450 employed workers. The national projected employment growth rate of 13.8% describes expectations for the occupation across the entire U.S. labor market, not for any particular metro. Within this national context, the top metros identified by LaborCove show a range of compensation and employment levels relative to these benchmarks. Several of the top‑ranked metros report median salaries above the national median, while others are closer to it, and the largest reported metro‑level employment count in the top 10 is smaller than the national employment figure because it reflects a single metropolitan area rather than the whole country.

New York-Newark-Jersey City, NY-NJ holds the #1 LaborCove ranking among metro areas for occupational therapists, with a Geography Score of 73.23. It has a reported employment count of 11,640, which matches the largest employment market value supplied in the geographic data, and exceeds the employment counts listed for all other metros in the top 10. The median annual salary for occupational therapists in New York-Newark-Jersey City, NY-NJ is $101,460. This is slightly above the national median salary of $100,330. New York’s combination of the highest reported Geography Score in the top 10, the largest metro‑level employment count in this group, and a median salary modestly above the national benchmark helps explain why it sits at the top of LaborCove’s metro rankings for this occupation.

Four California metros appear in the top 10: Los Angeles-Long Beach-Anaheim, CA (#2), San Jose-Sunnyvale-Santa Clara, CA (#3), San Francisco-Oakland-Fremont, CA (#4), and San Diego-Chula Vista-Carlsbad, CA (#8). All four report median salaries for occupational therapists that are higher than the national median of $100,330 and higher than New York-Newark-Jersey City, NY-NJ. Among these, San Jose-Sunnyvale-Santa Clara, CA reports the highest median salary at $136,870, followed closely by Vallejo, CA at $135,000 and San Francisco-Oakland-Fremont, CA at $136,770. Despite these elevated pay levels, San Jose-Sunnyvale-Santa Clara, CA and San Francisco-Oakland-Fremont, CA rank #3 and #4, respectively, with LaborCove Geography Scores of 60.84 and 60.54, both lower than New York-Newark-Jersey City, NY-NJ’s score of 73.23. Employment counts in these California metros are lower than New York-Newark-Jersey City, NY-NJ’s 11,640. Los Angeles-Long Beach-Anaheim, CA has 4,950 employed occupational therapists, San Francisco-Oakland-Fremont, CA has 1,560, San Diego-Chula Vista-Carlsbad, CA has 1,620, and San Jose-Sunnyvale-Santa Clara, CA has 840. This illustrates that the highest‑paying metros in the ranking do not necessarily have the largest employment counts or the top overall Geography Scores.

Chicago-Naperville-Elgin, IL-IN ranks #6 with a LaborCove Geography Score of 52.56 and employment of 5,960 occupational therapists. This employment count is higher than that of Los Angeles-Long Beach-Anaheim, CA’s 4,950 and Boston-Cambridge-Newton, MA-NH’s 4,790. However, Chicago-Naperville-Elgin, IL-IN’s median salary of $99,860 is slightly below the national median of $100,330. Boston-Cambridge-Newton, MA-NH ranks #7, with a Geography Score of 52.24 and employment of 4,790. Its median salary of $101,940 is above both the national median and the median salary in Chicago-Naperville-Elgin, IL-IN. These two metros illustrate that, within the middle of the top‑10 rankings, employment counts and salaries can move in different directions relative to the national benchmark and to each other. New York-Newark-Jersey City, NY-NJ remains distinct from both Chicago-Naperville-Elgin, IL-IN and Boston-Cambridge-Newton, MA-NH by combining a higher Geography Score (73.23) with a larger reported employment count and a median salary above the national median. Occupational therapists comparing large metro areas can see that different combinations of salary, employment, and Geography Score underpin the rankings in this group.

Three metros near the bottom of the top‑10 list—San Diego-Chula Vista-Carlsbad, CA (#8), Austin-Round Rock-San Marcos, TX (#9), and Vallejo, CA (#10)—show smaller reported employment counts than New York-Newark-Jersey City, NY-NJ, Chicago-Naperville-Elgin, IL-IN, Los Angeles-Long Beach-Anaheim, CA, and Boston-Cambridge-Newton, MA-NH. San Diego-Chula Vista-Carlsbad, CA reports employment of 1,620 and a median salary of $121,680, above the national median. Austin-Round Rock-San Marcos, TX has employment of 1,600 and a median salary of $122,050, also above the national median. Vallejo, CA reports employment of 100 and a median salary of $135,000, which is above both the national median and New York-Newark-Jersey City, NY-NJ’s median salary of $101,460. Despite its high median salary, Vallejo, CA ranks #10 with a LaborCove Geography Score of 50.42, below the scores for New York-Newark-Jersey City, NY-NJ (73.23), Los Angeles-Long Beach-Anaheim, CA (61.40), and San Jose-Sunnyvale-Santa Clara, CA (60.84). This further demonstrates that LaborCove’s Geography Score and resulting rank reflect more than pay alone, and that metros with smaller reported employment counts can still appear in the top 10 when other factors align.

LaborCove’s metro rankings for occupational therapists are based on authoritative labor‑market data and the LaborCove Geography Score, which combines factors including median annual salary, employment, and other internal metrics. Each metro receives a Geography Score and rank that summarize its position in LaborCove’s 2026 results. The figures in this article reflect national statistics for occupational therapists and metro‑level metrics for median salary, employment counts, and LaborCove Geography Scores where supplied. National projected employment growth is reported only for the occupation as a whole and is not applied to individual metros. Occupational therapists should treat these rankings as one structured input into their decision‑making. Personal considerations such as licensing, commuting, cost of living, and family needs are not captured in this dataset, so they should be evaluated separately from the LaborCove scores and rankings presented here.