Occupational Therapy Assistant Salary in Wilmington, NC: $65,223 (2026)

Wilmington, North Carolina, is experiencing a dynamic shift in the occupational therapy assistant job market, with a projected median salary of $65,223 for 2026. The full salary range for positions in this field varies significantly, from $49,739 at the 10th percentile to $88,077 at the 90th percentile. This data is derived from 2025 BLS OEWS surveys and reflects the current economic conditions. The differences in salary are greatly influenced by the employment sector, with skilled nursing facilities, schools, and hospital settings offering variable compensation structures. As the industry faces the repercussions of the post-Medicare cut realities, the demand for skilled occupational therapy assistants remains strong, making Wilmington an attractive location for new graduates and seasoned professionals alike.

The local market, with approximately 80 occupational therapy assistants employed in the area, presents unique opportunities for professionals looking to optimize their earnings. With a cost of living index of 96.422, residents in Wilmington generally experience lower living expenses, allowing for greater purchasing power despite the salary's below-national average status. Among local employers, hospital inpatient rehabilitation centers typically offer the highest pay, followed by outpatient clinics and some school district contracts. The variance in occupational therapy assistant pay in Wilmington, NC, is largely driven by workplace structure, productivity expectations, and employment settings. Positions in hospitals tend to pay more than skilled nursing facilities, which have faced budget cuts and lower reimbursements, such as the 15% Medicare reduction impacting OTA services. To maximize pay, aspiring occupational therapy assistants should consider positions in rehabilitation and outpatient settings, and also explore continuous education like COTA-to-MOT bridge pathways, providing additional leverage in a competitive job market.