Do I need a license to be a Occupational Therapist?

Requirements vary by state. Most states require some form of business license. Some trades require specific certifications or permits. Biz Wiz ($19.99) researches your specific state's requirements and builds them into your plan.

How much do occupational therapists make?

The median income for occupational therapists is $0/year. Top earners in busy markets make significantly more. Your income depends on pricing, volume, and keeping overhead low — which is why owning your tools instead of renting them matters.

How to Start a Occupational Therapist Business in 2026

Q: How much does it cost to start a Occupational Therapist business?

Startup costs for a Occupational Therapist business typically range from $500 to $5,000 depending on equipment and licensing. The biggest ongoing cost is software subscriptions ($100-200/month). Nexa eliminates that with a $279 one-time purchase.

Quick Answer: Starting a Occupational Therapist business costs $500-5,000 in startup costs. You need proper licensing for your state, the right equipment (A goniometer and dynamometer for range-of-motion and grip strength and more), and business tools (invoicing, scheduling, CRM). The median Occupational Therapist earns $0/year. Biz Wiz ($19.99) builds a personalized plan with your state's exact requirements. Nexa ($279 once or $99×3) replaces all the software subscriptions.

Bottom Line

Starting a Occupational Therapist business takes $500-5,000 in startup costs, proper licensing for your state, and business tools (invoicing, scheduling, CRM, bookkeeping). The median Occupational Therapist earns $0/year. Most new occupational therapists make the mistake of renting $100-200/month in software subscriptions from day one — that is $1,200-2,400/year before you have a single client. Nexa is $279 once for all of it. Biz Wiz ($19.99) builds you a personalized plan with your state's exact licensing requirements, pricing research for your area, and a 90-day action checklist.

The Steps

Figure Out the Legal Stuff

Every state is different. You may need a business license, trade-specific license, insurance, or permits. Don't skip this — getting caught without proper licensing can cost more than the license itself. Check your state's requirements →

Set Your Pricing

Research what occupational therapists charge in your area. Don't underprice to "get started" — you'll burn out. Price for profit from day one. Most occupational therapists charge based on job size, complexity, or hourly rate.

Get Your Equipment

You need: A goniometer and dynamometer for range-of-motion and grip strength, Therapy putty, hand-strengthening webs, and graded pegboards, Adaptive equipment: built-up utensils, sock aids, reachers, dressing sticks, A weighted-vest and sensory kit for pediatric regulation work, Splinting material and a heat gun for custom orthoses, A standardized assessment battery and a documentation laptop. Buy quality — you'll use these every day. This is a real investment, not a subscription you're renting. Own your tools from the start.

Set Up Your Business Tools

You need invoicing, scheduling, client tracking, and bookkeeping. Most occupational therapists pay $100-200/month renting these from 3-4 different companies. Or you can get Nexa — all of it for $279 once. You own it. See what the subscriptions really cost →

Find Your First 5 Clients

Start with people you know. Post on Nextdoor. Join local Facebook groups. Tell everyone what you do. Your first 5 clients become your first 5 reviews — and reviews are everything in this business.

Build Your Rhythm

Set a weekly schedule: when you work, when you do admin, when you market. Track your hours. Send invoices same day. Review your finances monthly. The occupational therapists who build a rhythm survive. The ones who wing it don't.

A Day in the Life of a Occupational Therapist

Morning is an evaluation, a retiree recovering from a wrist fracture who wants to get back to gardening and buttoning her own shirts. You take goniometer and grip readings, watch how she compensates reaching into a cupboard, and translate 'I want my life back' into measurable, functional goals an insurer will accept. Mid-morning is a pediatric session: a kid with sensory processing challenges who needs to regulate before he can sit for handwriting, so you run the heavy-work routine, then grade the pegboard task up as he settles. You document each session in language that shows skilled intervention, not babysitting, because the note is what gets the visit paid. After lunch you drive to a home-health visit where the patient's bathroom is too narrow for the recommended grab-bar placement and the real caregiver is an exhausted husband, so you redesign the toilet-transfer plan around what the room and the family can actually sustain. You fabricate a resting splint on the spot with heat-gun thermoplastic, fit it, and write the wearing schedule. Back at the desk, you handle an authorization that came back for six visits when the plan of care needs twelve, drafting the justification that ties more sessions to the specific functional milestones. You close the day building a home program a patient can run with a kitchen towel and a soup can instead of equipment they'll never buy.

Sound familiar? That's what happens when your tools don't talk to each other. Nexa connects everything — log a job, invoice from it, track the payment, update your books. One app. $279 once.

The Real Problems Occupational Therapists Deal With

Writing a home exercise program a patient will actually do with what's in their kitchen, then having no way to know if they touched it between visits
Insurance authorizing six visits when the functional goal needs twelve, so you're discharging a stroke patient mid-progress or writing appeals instead of treating
Driving forty minutes between home-health visits where the 'home program' has to work around a narrow bathroom doorway and a spouse who's the real caregiver
Justifying skilled OT versus 'just exercise' in every progress note, because a denied claim means the visit you already did doesn't get paid

Biz Wiz ($19.99) builds a plan around YOUR specific problems — not generic business advice.

Finally Start Your Occupational Therapist Business

$19.99

Everything you need to go from idea to open:

✓Occupational Therapist-specific business plan

✓Startup checklist (licenses, insurance)

✓90-day back office access

✓Tool budget calculator

✓Weekly guidance emails

✓Upgrade path when ready

Get Your Occupational Therapist Business Plan

✓ 30-day money-back guarantee

"I spent $19.99 on Biz Wiz and got a plan that told me exactly what licenses I needed, what to charge, and what to do first. I launched the next week."

— Small business owner, Biz Wiz customer

The Hidden Cost Nobody Mentions

Everyone talks about equipment costs. Nobody talks about the software tax.

Most occupational therapists end up paying $100-200/month for business software — invoicing, scheduling, bookkeeping, client management. That's $1,200-2,400/year. Over 5 years with price increases: $8,000-15,000. For tools you don't even own.

Nexa: $279. Once. Invoicing, scheduling, CRM, task management, and full QuickBooks-style accounting. You own it like you own your A goniometer and dynamometer for range-of-motion and grip strength.

FAQ

How much does it cost to start a Occupational Therapist business?

Depends on equipment and licensing. Typically $500-5,000 to start. The biggest ongoing cost is software subscriptions ($100-200/month) — which Nexa eliminates with a $279 one-time purchase.

Do I need a license?

Varies by state. Biz Wiz ($19.99) researches your specific state's requirements and includes them in your personalized plan.

How do I find clients?

Start local: Nextdoor, Facebook groups, word of mouth. Get 5 clients, get 5 reviews. Reviews compound. Your plan from Biz Wiz includes a marketing strategy tuned to your area.

Can I do this part-time?

Yes. Many occupational therapists start on weekends or evenings. The key is setting a rhythm you can sustain while keeping a day job.

How to Start a Occupational Therapist Business