How to decide between OT or OTA

How to decide between an OT or OTA career path

Are you trying to decide between becoming an occupational therapist or occupational therapy assistant?

You may have wondered how these jobs are different, how difficult it will be to get a job, the cost of tuition, salary, or if OT is really worth it.

Deciding between OT and OTA may be giving you a headache, but here are a few ideas that can help you piece it all together.

How are OTs and OTAs different

Occupational Therapists have a masters or doctorate degree while occupational therapy assistants have an associates degree. 

OTs and OTAs have different responsibilities and roles. While an OT can evaluate and treat patients.  An OTA is only able to provide treatments.

If a patient has a change in status or condition, an OT is required to do a revaluation or reassessment to modify the plan of care.

Most patients require an initial evaluation by a OT. In the evaluation, an OT will create a plan of care with a list of goals that can be completed by an OTA.

If an OTA thinks a different type of treatment may be needed, they will need to consult with an OT and have them change the plan of care.

Another key difference between OTs and OTAs is billing. Medicare and other insurance companies may not provide as much reimbursement for OTA services. This is why OTAs usually have a lower salary than OTs.

How to decide on right career

Deciding on a career path as an OT or OTA is a personal decision, but for me it was clear to go to OT school. I already had a bachelors degree, and I didn’t have a lot of debt, but everyone’s circumstance is different.

I’m you’re interested in a career in OT or OTA, I highly recommend finding an OT mentor or coach who can walk you through the steps. I actually provide this service, but you can also checkout my course to learn the steps to becoming an OT.

OT vs OTA job demand

The job demand for OT and OTA is high, but it will always be higher for OTs. An OTA cannot see patients for the initial evaluation and some facilities won’t even hire them.

There are many fields that are desperate for both OTs and OTAs. These fields usually include

  • Skilled nursing facilities
  • Rehabs
  • Home health
  • Schools

In larger cities, there is a greater need for occupational therapy assistants, and in these cities they usually have a much easier time  working in hospitals and outpatient clinics (hand therapy).

As an OT or OTA, you really can get any type of job in occupational therapy.  You just need to be patient and flexible.

Cost of tuition

The average total cost for OT school is $95,000 while the average cost for OTA school is $29,000.  

The cost of tuition varies greatly depending on where you go.  You may need to pay more or less depending on the school and your state of residency.  

Most OT schools have tuition costs between $20,000-115,000 while most OTA schools cost between $4000-40,000. 

For more information on the most affordable OT schools check out this article here

How to choose a school

Choose a school that has a good track record of maintaining accreditation.  Some say you should look at their pass rate for the NBCOT exam, but I disagree. 

Next, do your research and contact students who are attending these schools via social media. Ask about the program, administration, faculty, and difficulty level, and acceptance rate.

Ask if they feel well prepared to be an OT.  

When I graduated I didn’t feel that my school prepared me to be an OT, but I felt that my fieldwork did prepare me.  

Average OT vs OTA salary

OT Salary by state

OTA Salary range can vary greatly depending on where you work and the type of setting.

On average, full time OTs make about $85,570 per year while OTAs make about $66,250 ( Read my full OTA salary report here.

You should also know that it’s much easier for an OT to increase their pay rate than an OTA.  For example, some PRN OTs can make up to $25/hour or more if they work per diem.  

Per diem OTA’s are usually not able to make nearly this much.  

If you want to learn how to maximize your OT salary, read my other post here

Tuition Reimbursement

Most tuition reimbursement programs are only offered to OTs, but there are some options for OTAs.  

If you’re looking for a job that doesn’t offer tuition reimbursement, learn how to negotiate for a sign on bonus.

Many OT and OTA jobs will negotiate $2,500-5,000 to sign on for a full-time position.

Is OT worth it?

I think this answer is different for everyone.  Occupational therapy can be an exciting and meaningful career if you make it meaningful to you.  

I currently work at a hospital and there are days that I feel burned out.  Sometimes I wish I only worked part time.  There are other days that I feel that I made a difference in someone’s life and those days are the best.

I’ve found that the more I learn and grow in the field of OT, the more I enjoy it.  I’ve also found that starting my own business is a lot more motivating and meaningful than working for a hospital or clinic.

OT is a great job, but you will eventually need to make it unique and meaningful to you, and that’s where an OT coach can help.

How to become an OT without a degree

You may have wondered if there’s a way to become an OT without a degree.  You must go to a school and pass the NBCOT exam to become an OT, but that doesn’t mean you can’t work in the same field as an OT.

Right now there are two fields of OT that don’t require an OT degree: Ergonomics and driver rehab.  While I would encourage you to have some kind of certification, it’s not required. 

However, some states may have specific requirements to work in these fields, but you don’t have to be an OT. 

You will also need to know how to start your own business and market yourself. It can be a challenging process, but this can save you thousands if you decide to choose this route instead of OT school. 


Sometimes I wonder if I should have done things differently , but I’m usually glad that I didn’t choose a different field in medicine. 

If you’re still trying to decide between OT and OTA, I would make a list of pros and cons and decide on what makes the most sense for you. Then make a decision and listen to your heart as you continue to move forward with that decision.  

That’s what I did.

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