Time Machine

Occupational therapy assistants

Name: Occupational Therapy Assistants: employment and wages since 1965
Creator: Future History
License: https://futurehistory.earth/terms

In brief

In May 2025, BLS counted 51,290 US occupational therapy assistants, with median pay of $72,300 a year. Of the BLS counts since 2012, the May 2025 count is the highest. The earliest figure here is an estimate of 1,200 from 1965, not measured the same way as today's count. The last full technology era for occupational therapy assistants: Electronic health records and software-based billing, 2005 to 2018.

Official statistic: latest count and pay, highest count.Researched context: earliest figure.

What the sources say

Official outlook

BLS projects employment to grow 21.5% from 2025 to 2035.

BLS Employment Projections 2025-35

Official statistic

AI exposure studies

23.3% of this job's tasks are exposed to large language models. Not a forecast of job losses. Eloundou and others, 2023 Official statistic

Data as of BLS OEWS May 2025; BLS Employment Projections 2025-35. BLS publishes these counts as yearly survey snapshots and cautions against reading them as a precise trend. In May 2021 BLS changed how it estimates these counts (a model-based method using three years of survey data) and moved fully to the 2018 occupation codes, so part of a change across 2021 can come from the method rather than the work.

Last updated 11 October 2026.

Cite this page

APA

Future History. (2026, October 11). Occupational therapy assistants: jobs and pay since 1965 [Data set; data as of BLS OEWS May 2025; BLS Employment Projections 2025-35]. https://futurehistory.earth/timeline/31-2011

Chicago

Future History. "Occupational therapy assistants: jobs and pay since 1965." Data as of BLS OEWS May 2025; BLS Employment Projections 2025-35. Last modified October 11, 2026. https://futurehistory.earth/timeline/31-2011.

BibTeX

@misc{futurehistory_31_2011, author = {{Future History}}, title = {Occupational therapy assistants: jobs and pay since 1965}, year = {2026}, month = oct, howpublished = {\url{https://futurehistory.earth/timeline/31-2011}}, note = {Last updated 2026-10-11. Data as of BLS OEWS May 2025; BLS Employment Projections 2025-35}, }

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19752000now

2026

Known then as Occupational Therapy Assistant (hospital-based training programs)

Known then as Certified Occupational Therapy Assistant (COTA) -- first standardized credential

Known then as Certified Occupational Therapy Assistant (COTA) -- 2-year degree era

Known then as Occupational Therapy Assistants (BLS SOC 31-2011)

Known today as Occupational Therapy Assistants (BLS SOC 31-2011)

Projected to still be called Occupational Therapy Assistants (BLS SOC 31-2011)

Data from the May 2025 survey

US Employment

51K

Est.

Stated in source: BLS OEWS

Official statistic

Report an error

Median Annual Wage

$72,300

≈ $70,446 in 2024 prices (derived by us, CPI-adjusted)

Official statistic

Report an error

Beat · 1917

March 15-17, 1917: six founders gather in Clifton Springs, New York and establish the National Society for the Promotion of Occupational Therapy (NSPOT). The founding vision states: "The advancement of occupation as a therapeutic measure; for the study of the effect of occupation upon the human being; and for the scientific dispensation of this knowledge." No assistant credential exists yet; the entire profession is unified under the single title of occupational therapist. NSPOT formally renames itself the American Occupational Therapy Association (AOTA) in 1921.

Beat · 1951

1951: AOTA adopts "Personnel Policies for Occupational Therapists," the first formal recognition that non-professional assistants are working alongside credentialed OTs and that their roles need policy definition. The document references "charges for services by OTs, non-professional assistants, and facilities," an early acknowledgment that aides and helpers are performing meaningful clinical-support tasks in practice even before any formal training standard exists.

Beat · 1958

1958: AOTA adopts formal educational standards for the Certified Occupational Therapy Assistant and approves the first OTA training programs, specifically designed for psychiatric hospital settings. AOTA president Ruth Robinson had spent three years advocating for this credential, arguing that a well-defined assistant role could safely relieve the severe OT shortage in state psychiatric institutions without compromising patient care. The first programs are hospital-based 12-week certificates, not college degree programs.

Beat · 1964

1964: The Certified Occupational Therapy Assistant (COTA) credential is formally established. St. Catherine University (then the College of St. Catherine) opens what is cited as the first college-based OTA program in the country. The move from hospital-based certificates to accredited college programs signals a shift from emergency workforce stopgap to recognized profession with entry-level educational standards. St. Mary's Junior College offers the first externally approved college program in 1965.

Beat · 1965

1965: Medicare is enacted (P.L. 89-97), creating the federal reimbursement framework that will drive the largest expansion of OT services in history over the following five decades. Occupational therapy is included as a covered service under Medicare Part B for outpatient settings and under the skilled nursing facility benefit. Without this reimbursement anchor, the massive SNF-sector OTA workforce of the 1980s and 1990s could not have developed. Medicare reimbursement policy will subsequently shape the profession's headcount at each turn: the SNF PPS boom of the 1990s, the Balanced Budget Act cuts of 1997, and the 2022 OTA payment differential all ripple through BLS employment figures.

Beat · 1973

1973: AOTA establishes the COTA Career Mobility Program, which formally creates pathways for OTAs to advance their credentials and eventually qualify as registered occupational therapists (OTRs) through bridge coursework. The same year, AOTA formally delineates the roles of OTs and COTAs, clarifying which clinical tasks can be delegated to an assistant under OT supervision. This role delineation document becomes the foundation for state practice acts over the following decade.

Beat · 1975

1975: The Education for All Handicapped Children Act (P.L. 94-142) is signed into law, specifically identifying occupational therapy as a "related service" that school districts must provide to eligible students with disabilities. This opens an entirely new OTA practice setting: the public school. School-based OT positions grow steadily through the late 1970s and 1980s, eventually accounting for a meaningful share of the COTA workforce alongside the SNF-dominant segment. Florida and New York pass the first state OT licensure laws the same year, signaling the beginning of a state-by-state credentialing regime that will encompass all 50 states by the 1990s.

Beat · 1976

1976: COTAs gain full voting rights within AOTA and become eligible for election to the AOTA Executive Board. This is a significant marker of professional recognition: OTAs are no longer merely a workforce tier supervised by "real" therapists but full members of the professional community. The 1978 creation of a Roster of Honor to recognize COTA contributions to professional development reinforces the integration.

Beat · 1997

1997: The Balanced Budget Act establishes annual per-beneficiary Medicare spending limits ("therapy caps") for outpatient occupational therapy services under Part B. Research published in the Archives of Physical Medicine and Rehabilitation would later find that the BBA did not actually reduce OT utilization among Medicare beneficiaries, but the policy uncertainty and reimbursement changes slowed SNF hiring of OTAs in the late 1990s. The caps would be implemented in 1999, moratoriums would suspend them repeatedly through the mid-2000s, and they would finally be permanently repealed in 2018 -- but the 1997-2018 cap era cast a persistent shadow over SNF-sector OT staffing decisions.

Beat · 2000

Circa 2000: the COTA credential completes a full transition from hospital-based 12-week certificate programs to accredited associate-degree programs. The Cottrell (2000) historical review in the American Journal of Occupational Therapy documents the trajectory from 2 hospital-based programs in 1958 to 162 accredited 2-year college degree or professional certificate programs by 2000. The workforce expansion from the hundreds to the tens of thousands tracked the program expansion almost directly.

Beat · 2022

January 1, 2022: the Medicare 15% OTA payment differential takes effect under Section 53107 of the Bipartisan Budget Act of 2018. CMS now requires a CO modifier on any occupational therapy claim where an OTA provided the service in whole or in part; attaching that modifier triggers a 15% payment reduction relative to what an OT would receive for the same service. AOTA has lobbied continuously for repeal. The policy creates a structural incentive for employers to prefer OTs over OTAs for Medicare Part B billing -- a tension that affects hiring patterns and wage negotiations across the profession without reducing patient demand for OTA services.

How to read this number

OEWS is a point-in-time survey snapshot, not a continuous time series; BLS advises against using it for year-over-year trend comparison.

Each dot is a cited figure over time; the dotted line only links them (values between aren't measured). Hollow dots are estimates.

Official statistic: Copied by a script from a statistics agency table or a published study's table, not retyped by hand. BLS figures, ONS ASHE figures (UK pay and jobs) and the forecast and exposure tables are also re-checked against that table on every data run. Researched context: Researched from the cited source rather than copied from it by a script, so it is not machine-checked yet. Spot a mistake? Each figure has a “Report an error” link.

How it began · 1958

In 1958 the American Occupational Therapy Association confronted a blunt arithmetic problem: the post-war expansion of psychiatric hospitals, veterans' rehabilitation programs, and polio recovery wards had created more patients requiring occupational therapy than registered therapists could serve. The solution the AOTA adopted was to create a new tier of practitioner, formally designating educational standards for what it called the Occupational Therapy Assistant, and approving the first OTA training programs specifically designed for psychiatric settings. These were hospital-based, 12-week certificate courses, offered primarily at state mental hospitals where the chronic staffing shortage was most acute. Ruth Robinson, who served as AOTA president from 1955 to 1958, was the central advocate: she had spent years arguing that carefully trained supportive personnel could perform defined clinical tasks under the supervision of a registered occupational therapist, and that creating this role was both safe and necessary. The credential formally crystallized in 1964, when the Certified Occupational Therapy Assistant designation was created and St. Catherine University launched what is cited as the first college-based OTA program in the country. St. Mary's Junior College offered the first approved college program in 1965. The profession was tiny in its early years: the United States had only a few hundred certified practitioners in the late 1960s. What transformed it was legislation. The passage of Medicare in 1965 created the reimbursement infrastructure that allowed occupational therapy services to be billed to federal programs, and with it came the first sustained economic incentive for hospitals and nursing homes to hire more OT staff at every credential level. The COTA had been born out of scarcity; it would be built into a stable career by the steady expansion of Medicare-funded post-acute care over the following six decades.

Cited forecasts · present → 2035

Will AI replace occupational therapy assistants? What the research says

Each figure is stated by the named source; we publish no forecasts of our own. Where sources disagree, we show the disagreement rather than an average.

Each figure is stated by the named source; we publish no forecasts of our own. Where sources disagree, the spread is the honest signal.

What published forecasts say

Forecast change in the number of people doing this work, as published by each named source. Bars share one scale on every role, centred on zero and reaching the end at ±30%. Grey marks a small change, 3% or less either way.

BLS Employment Projections 2025-35
Target year 2035
+21.5%
BLS National Employment Matrix, 2025-35 cycle, line for SOC 31-2011 (Occupational therapy assistants): 52.2 thousand jobs in 2025, projected 63.4 thousand in 2035, a change of +11.2 thousand (+21.5%). Matrix employment counts all jobs in the occupation, including self-employed workers. The average for all occupations in this cycle is +3.5%.
Official statisticReport an error

How exposed is this work to AI (research measures)

Scores as published by each study. Each row says what it measures. These measure what AI could technically do, not forecasts of jobs lost.

Eloundou et al. (2023), "GPTs are GPTs"
2023 study · Share of tasks exposed to LLMs (β, human-rated)
23.3%
of tasks
What this measures
Published occupation-level exposure from the paper's occ_level.csv for O*NET-SOC 31-2011.00 Occupational Therapy Assistants. Shown: human-rated β = 0.233, the share of the occupation's tasks an LLM could do in at least half the time at equal quality, counting tasks that need LLM-powered software at half weight (β = E1 + 0.5 × E2). Other published measures for this occupation: human-rated α (LLM alone) 0.14 and γ (all LLM-assisted) 0.326; GPT-4-rated β 0.267. This measures how much of the work an LLM could touch, not how many jobs disappear.
Official statisticReport an error

Today, in this role

What's changing day to day for occupational therapy assistants

Three parts of your work where AI is already doing real lifting, and what stays yours.

AI is sitting alongside you here Instruct, or assist in instructing…

, patients and families in home programs, basic living skills, or the care and use of adaptive equipment.^[2]

Where your edge is

AI is sitting alongside you here Maintain and promote a positive attitude toward clients…

and their treatment programs.^[2]

Where your edge is

AI is sitting alongside you here Report to supervisors, verbally or in writing…

, on patients' progress, attitudes, and behavior.^[2]

Where your edge is

Tools of the era

How has the work of occupational therapy assistants changed since 1917?

The tools that defined the work, one line per era. Select an era to see how it reshaped the work.

Craft and occupational media (basketry, weaving, woodworking, gardening)
The founding of the National Society for the Promotion of Occupational Therapy in 1917 institutionalized the use of purposeful activity as a therapeutic medium. Early practitioners prescribed crafts -- basket weaving, chair caning, brush making, weaving, and woodworking -- not as diversionary hobbies but as structured interventions intended to restore motor function, cognitive engagement, and psychological equilibrium. OT educator Louis J. Haas catalogued many craft types available for patients in 1921, of which many remained in active therapeutic use. Tools were workshop-grade hand implements: looms, crochet hooks, hand saws, pottery wheels, and garden trowels. The 1912 textbook by Susan Edith Tracy, "Studies in Invalid Occupation," served as the practical training manual. These craft media remained the primary therapeutic tool well into the 1950s and shaped what assistants in the earliest programs were trained to teach and guide.
Adaptive equipment and ADL training (reachers, dressing aids, orthotics, splinting)
As occupational therapy professionalized and the assistant credential took form, the tool kit expanded from craft media toward adaptive equipment and activities-of-daily-living (ADL) training. The physical rehabilitation era, accelerated by the mass care of World War II veterans and the polio epidemics of the 1940s and 1950s, established a new clinical vocabulary: dressing sticks, button hooks, long-handled reachers, universal cuffs, orthotic splints. OTAs trained in the new hospital-based programs learned to fabricate low-temperature thermoplastic splints by hand and to guide patients through systematic ADL retraining. A. Jean Ayres published her foundational work on sensory integration in the early 1970s, opening a new practice area and a new set of clinical tools: weighted vests, tactile brushing protocols, and sensory obstacle courses. The 1975 Education for All Handicapped Children Act (P.L. 94-142) created a school-based OT market for which sensory integration and motor development tools became standard equipment.
Paper-based documentation, goniometers, and manual functional assessments
Through the 1970s, 1980s, and into the early 2000s, OTA clinical work was documented entirely on paper: handwritten SOAP notes, manual goniometer readings for joint range-of-motion, hand-grip dynamometer measurements, and standardized paper-and-pencil assessments such as the Allen Cognitive Level Screen. The paper documentation era imposed a significant administrative load: every treatment session required a narrative note, and billing relied on manually typed encounter forms submitted to payers. The goniometer -- a simple, low-cost angle-measurement device -- was the most universal clinical instrument, used across every OTA practice setting. Physical measure tools like the pinch gauge and the nine-hole peg test required no electricity and could be administered by an OTA under supervision in any environment. The discipline of documentation itself was codified: AOTA adopted "Uniform Terminology for Occupational Therapy" in 1979, creating a shared clinical vocabulary that the paper record organized.
Electronic health records (EHR) and software-based billing (e.g., ReDoc, Net Health, Therasoft)
The HITECH Act of 2009 and subsequent CMS incentive programs for meaningful use of electronic health records accelerated EHR adoption across all healthcare settings, including the outpatient rehabilitation and SNF environments where most OTAs work. Specialty OT practice management software -- ReDoc, Net Health, Therasoft, WebPT -- replaced paper SOAP notes with templated electronic documentation, automated CPT code selection, and direct electronic billing to payers. For OTAs, the shift was significant: the documentation component of each session became software-mediated, requiring competency with a keyboard and EHR interface rather than pen-and-paper. Accreditation Council for Occupational Therapy Education (ACOTE) standards began formally requiring EHR instruction in OTA programs, a recognition codified in the literature around 2008. The transition also introduced a new compliance burden: electronic records are auditable, and Medicare and Medicaid reimbursement now depended on documentation specificity that paper notes had allowed to be more informal.
Telehealth platforms, tablet-based assessment apps, and AI documentation assistants
The COVID-19 pandemic dramatically accelerated telehealth adoption in occupational therapy: state waiver programs and CMS emergency rules allowed OTAs to deliver services by video for the first time in most jurisdictions. Tools like Zoom Health, Doxy.me, and purpose-built rehab telehealth platforms entered OTA clinical practice rapidly after March 2020. Simultaneously, tablet-based assessment apps (Motion Analysis apps, the virtual Nine-Hole Peg Test, computerized cognitive screening) began supplementing or replacing paper instruments, particularly in pediatric and school-based settings. AI-assisted documentation tools, which transcribe and draft clinical notes from ambient audio or structured prompts, began entering the OT practice management ecosystem from around 2023. These tools reduce the documentation burden but also raise questions about clinical specificity and compliance that professional associations and payers are still resolving. The mainstream daily-driver tool for an OTA in 2025-26 is an integrated EHR platform (Net Health, Casamba, or similar) accessed via a shared clinic tablet or desktop, supplemented by an expanding set of app-based assessment instruments.

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Occupational Therapy Assistants employment and pay by year

On record since1958

Latest US employment51,290 (May 2025)Source: BLS OEWS May 2025Official statisticReport an error

Latest US median pay$72,300 (May 2025)Source: BLS OEWS May 2025Official statisticReport an error

Outlook+21.5% by 2035Source: BLS Employment Projections 2025-35Official statisticReport an error

View all 25 years of cited US data, each linked to its source

Occupational Therapy Assistants in the US: employment and pay by year, with sources
Year	US employment	Annual pay (median unless marked)	Source	Report
1965	1,200	n/a	Est., St. Kate's OTA Online [1] Researched context	Report
1976	6,000	n/a	Est., OT Centennial Project [2] Researched context	Report
2003	18,940	$37,400	BLS OEWS May 2003 [3] Official statistic	Report
2004	20,880	$38,430	BLS OEWS May 2004 [3] Official statistic	Report
2005	22,160	$39,750	BLS OEWS May 2005 [3] Official statistic	Report
2006	23,700	$42,060	BLS OEWS May 2006 [3] Official statistic	Report
2007	25,130	$45,050	BLS OEWS May 2007 [3] Official statistic	Report
2008	25,610	$48,230	BLS OEWS May 2008 [3] Official statistic	Report
2009	26,680	$50,250	BLS OEWS May 2009 [3] Official statistic	Report
2010	27,720	$51,010	BLS OEWS May 2010 [3] Official statistic	Report
2011	29,130	$52,040	BLS OEWS May 2011 [3] Official statistic	Report
2012	29,500	$53,240	BLS OEWS May 2012 [3] Official statistic	Report
2013	30,450	$55,270	BLS OEWS May 2013 [3] Official statistic	Report
2014	32,230	$56,950	BLS OEWS May 2014 [3] Official statistic	Report
2015	35,460	$57,870	BLS OEWS May 2015 [3] Official statistic	Report
2016	38,170	$59,010	BLS OEWS May 2016 [3] Official statistic	Report
2017	41,650	$59,310	BLS OEWS May 2017 [3] Official statistic	Report
2018	42,660	$60,220	BLS OEWS May 2018 [3] Official statistic	Report
2019	44,990	$61,510	BLS OEWS May 2019 [3] Official statistic	Report
2020	42,750	$62,940	BLS OEWS May 2020 [3] Official statistic	Report
2021	41,980	$61,730	BLS OEWS May 2021 [3] Official statistic	Report
2022	43,810	$64,250	BLS OEWS May 2022 [3] Official statistic	Report
2023	46,090	$67,010	BLS OEWS May 2023 [3] Official statistic	Report
2024	47,910	$68,340	BLS OEWS May 2024 [3] Official statistic	Report
2025	51,290	$72,300	BLS OEWS May 2025 [3] Official statistic	Report

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Craft and occupational media (basketry, weaving, woodworking, gardening) (1917 to 1958)

Adaptive equipment and ADL training (reachers, dressing aids, orthotics, splinting) (1958 to 1980)

Paper-based documentation, goniometers, and manual functional assessments (1975 to 2005)

Electronic health records (EHR) and software-based billing (e.g., ReDoc, Net Health, Therasoft) (2005 to 2018)

Telehealth platforms, tablet-based assessment apps, and AI documentation assistants (2018 to present)

Occupational Therapy Assistants employment and pay by year

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