If you are a pediatric occupational therapist, you may have noticed that working harder does not always translate into earning more. Many OTs reach a point where their schedule is full, their workload is heavy, and yet their income feels stuck.
The reason is simple. Income for pediatric OTs is shaped less by effort and more by structure. The setting you work in, the type of caseload you carry, and how much unpaid work you are expected to absorb all play a major role in what you actually take home.
This guide walks through realistic, sustainable ways pediatric OTs can increase income without burning out or sacrificing clinical quality.
Why Many Pediatric OTs Feel Underpaid
Most pediatric OTs are paid for direct session time but spend hours each week on work that is never compensated. This includes documentation, parent communication, scheduling issues, insurance follow-ups, and cancellations.
Over time, this unpaid work lowers your real hourly rate far below what your salary or hourly pay suggests. A role that looks like 45 dollars per hour on paper may be much closer to 30 once all time is accounted for.
Increasing income often starts with increasing your real hourly rate, not just your number of sessions.
Understand Your Real Hourly Rate
Before making changes, it helps to understand what you are actually earning.
To calculate your real hourly rate, divide your total weekly pay by all the hours you work, including unpaid time. This includes documentation, communication, cancellations, commute time, and meetings.
Many pediatric OTs discover their real hourly rate is 20 to 40 percent lower than expected. This awareness alone helps guide better decisions about where and how to work.
Choose Higher-Paying Pediatric OT Settings
Income varies significantly by setting.
Outpatient clinics and schools often offer stability, but they also come with productivity expectations and unpaid administrative work that cap earnings.
In-home pediatric OT, early intervention, and independent caseloads tend to offer higher per-session rates. When structured well, these models can dramatically increase real hourly pay.
The key is density. Higher pay only helps if sessions are local, cancellations are managed, and admin work is minimized.
Add a Side Caseload Without Overloading Yourself
Many pediatric OTs increase income by adding a small side caseload rather than changing jobs entirely.
Even one to three additional sessions per week at a higher rate can meaningfully increase monthly income. The goal is not volume. The goal is efficiency.
A well-designed side caseload should be flexible, local, and supported so it does not add hours of unpaid work.
Reduce the Admin Work That Drains Your Income
Administrative work is one of the biggest barriers to higher income for pediatric OTs.
Tasks like billing, chasing payments, handling insurance denials, managing scheduling, and marketing yourself locally can add hours each week without increasing pay.
Reducing or outsourcing these tasks increases income even if your session rate stays the same. Less unpaid work means a higher real hourly rate.
Avoid Income Traps That Lead to Burnout
Not every income strategy is sustainable.
Common traps include
• taking on more sessions without reducing unpaid work
• accepting low per-visit rates for convenience
• managing billing and insurance without support
• expanding travel radius too far
• relying on inconsistent or delayed payments
These approaches often increase stress without increasing take-home pay.
Sustainable income growth comes from better systems, not longer days.
How Coral Care Helps Pediatric OTs Increase Income
Coral Care supports pediatric OTs who want higher income without running a full private practice.
Coral Care pays top rates, quickly, and reliably. Providers are paid within 30 days or less and do not chase families or insurance for payment.
Coral Care handles
• insurance billing and claims
• denials and appeals
• authorizations
• credentialing
• scheduling and cancellations
• parent communication management
OTs choose their travel radius, set their availability, and build a local caseload that fits their life. Documentation is streamlined and typically takes less than 15 minutes per session.
There are no minimum hours and it is free to get started.
For many pediatric OTs, even a small Coral Care caseload significantly increases monthly income while reducing unpaid administrative time.
Focus on Sustainability, Not Just Pay
The highest-earning pediatric OTs are not necessarily the busiest. They are the ones with predictable schedules, reliable payment, and minimal unpaid work.
Increasing income is not about doing more. It is about working in models that respect your time.
The Bottom Line
Pediatric OTs deserve income that reflects the full scope of their work. If your current role leaves you feeling stretched thin and underpaid, there are ways to increase income without burning out.
Start by understanding your real hourly rate. Then look for opportunities that offer higher per-session pay, fewer unpaid tasks, and reliable payment.
If you want to increase your income while focusing on care, exploring a supported in-home model like Coral Care may be a meaningful next step.
