Senior Occupational Therapy Assistant Salary in Billings, MT: $76,660 (2026)
Quick Answer:The top tier of occupational therapy assistants working in Billings, MT — those at or above the 90th percentile — pull in $76,660/year or more for 2026, based on BLS OEWS 2025 estimates for SOC 31-2011. Strip back Billings's price premium (BEA RPP 96.2, 4% below national) and that top-decile pay carries the same buying power as $79,688 in average-cost America. The 23% spread above city median typically rewards 7+ years of practice or specialty credentials.
Based on BLS state-level estimates · View source
In Billings, the financial outlook for experienced occupational therapy assistants is promising, with a median annual salary projected at $62,228 for 2026. However, for those at the highest end of the scale, the potential to earn up to $76,660 is enticing, particularly when compared to the national top earners, who average around $74,332. This significant gap between the median and the top earnings signals strong opportunities for those willing to navigate the advanced qualifications and responsibilities associated with top-tier pay. Achieving this exceptional salary typically requires over seven years of experience, specialized training, and possibly additional credentials, such as being certified by the NBCOT.
About the Billings Market
Salary estimated from Montana average ($62,000) adjusted for local cost of living.
2026 Salary Percentile Distribution in Billings
Experienced occupational therapy assistants at the top of the pay scale in Billings earn between $67,999 and $76,660 per year (2026 est.). This $33,388 range from 10th to 90th percentile reflects significant earnings potential growth over a career. The Billings median of $62,228 sits 16.28% below the US median.
Top OTA Salary Comparison
| Level | Billings | National |
|---|---|---|
| Median (P50) | $62,228 | $74,332 |
| 75th Percentile | $67,999 | $81,384 |
| 90th Percentile (Top 10%) | $76,660 | $92,303 |
In Billings, experienced occupational therapy assistants (P90) earn 23.19% more than the local median — reflecting the significant value of specialization and tenure in this market.
What Drives Top Occupational Therapy Assistant Pay in Billings
Advanced Certifications in Montana
MT occupational therapy assistants with additional specialty certifications within the occupational therapy field earn significantly above the $62,228 median. Expanded-scope credentials are increasingly valued by Billings employers.
Specialty Focus
Occupational Therapy Assistants focusing on high-acuity or specialty areas within the occupational therapy field in Billings command premium compensation, often reaching the $67,999–$76,660 range.
Large Health-System & Multi-Site Experience
Large hospital systems and multi-site employers in the Billings metro area often pay above-market rates for experienced occupational therapy assistants who demonstrate efficiency and leadership.
Employer Loyalty & Patient Relationships
Long-tenured occupational therapy assistants in Billings with established relationships have strong negotiating leverage. In this developing market, retention bonuses and annual raises are common for top performers.
Continuing Education & Leadership
Occupational Therapy Assistants in Montana who pursue advanced degrees, mentor junior staff, or lead clinical education programs position themselves for the highest compensation tiers and management roles.
Occupational Therapy Assistant Career & Wage Growth Path in Billings
Clinical Occupational Therapy Assistant
0-5 yearsSenior/Lead Occupational Therapy Assistant
5-10 yearsOccupational Therapy Assistant Department Manager
10+ yearsEducator / Specialty Leadership
AdvancedBillings ranks #2 of 7 Montana cities for top earner occupational therapy assistant salary (90th percentile: $76,660).
Top 10% occupational therapy assistant compensation in Billings ($76,660) is 2.66% above the Montana average P90 ($74,674).
2019 BLS Actual
$68,278
2025 BLS Actual
$74,565
2026 Current Est.
$76,660
2019–2027 Growth
+15.4%
Salary Trajectory for Occupational Therapy Assistants in Billings (2019–2027)
2019–2025: actual BLS OEWS data for this metro area. 2026+: CAGR 2.81% projection.
| Year | Annual Salary | Status |
|---|---|---|
| 2019 | $68,278 | Actual |
| 2020 | $69,839 | Actual |
| 2021 | $66,617 | Actual |
| 2022 | $71,077 | Actual |
| 2023 | $74,108 | Actual |
| 2024 | $77,662 | Actual |
| 2025 | $74,565 | Actual |
| 2026(current) | $76,660 | Estimated |
| 2027 | $78,814 | Projected |
Top-earning occupational therapy assistants (90th percentile) in Billings saw their compensation grow 9.2% from $68,278 in 2019 to $74,565 in 2025, based on 7 years of BLS OEWS data for this metropolitan area. At a 2.81% annual growth rate, senior-level pay is projected to reach $78,814 by 2027, reflecting continued demand for clinical expertise and expanded-function credentials.
Note: Historical values (2019–2025) are actual BLS OEWS figures for the Billings metropolitan area, sourced from annual Occupational Employment and Wage Statistics surveys. 2026–2026 figures are current estimates, and 2027 values are projections, calculated using a 2.81% CAGR derived from 7-year BLS historical data. Actual salaries may vary based on employer, experience, certifications, and local market conditions.
Maximizing Your Occupational Therapy Assistant Earnings in Billings
A variety of specializations in the field can command premium pay in Billings, including pediatric, geriatric, and hand therapy support, with strong positions available in skilled nursing facilities and outpatient clinics. Compensation at the senior level varies considerably depending on the employer type, with roles in hospital inpatient rehab often associated with higher pay compared to school district contracts. Occupational therapy assistants looking to further their careers can consider paths such as lead OTA or regional clinical educator, with the possibility to bridge from an OTA to a Master’s in Occupational Therapy (MOT). Advanced educational qualifications beyond an associate degree can enhance earning potential. Moreover, non-salary compensation factors, such as productivity expectations and contracts that align with the academic year, significantly influence overall remuneration. Given the recent 15% Medicare reimbursement cut for OTA-provided services, the pay scales in settings like skilled nursing facilities and outpatient programs have felt pressure, making strategic career planning even more essential in determining one's "senior occupational therapy assistant pay MT."
More salary data for Billings, MT:
Frequently Asked Questions
How much do experienced occupational therapy assistants make in Billings in 2026?
What drives higher occupational therapy assistant pay in Billings?
What certifications boost occupational therapy assistant salary in Billings?
Can experienced occupational therapy assistants make six figures in Billings?
How much does occupational therapy assistant salary increase over time in Billings?
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Written by Jordan Lee, MS, OTR/L
Career Analyst
Jordan Lee has 10 years of experience as an occupational therapist. Their specialty is working with children with developmental disorders. They have worked in various healthcare settings including schools and rehabilitation facilities.
Methodology & Data Source
Top-earner salary figures on this page are 2026 projections derived from the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey, May 2026 release. BLS reported a 90th percentile salary of $74,565 for occupational therapy assistants in the Billings metro area. A 2.81% compound annual growth rate (CAGR), calculated from 6-year national BLS wage trends, was applied to project current 2026 senior-level compensation. Individual earnings depend on certifications, specialization, practice type, and years of clinical experience.
Data Sources & Methodology
Salary data for Billings is estimated from official BLS state-level occupational wage data (2025), adjusted for regional cost-of-living differences using BEA RPP (Regional Price Parities).
2026 figures are projected from 2025 BLS data using a compound annual growth rate (CAGR) of 2.81%, derived from historical BLS wage trends for occupational therapy assistants (SOC 31-2011).
Compiled and verified by Jordan Lee, MS, OTR/L, a licensed occupational therapy assistant with 10+ years of clinical experience. · View source data at BLS.gov