Occupational therapy vs physical therapy

Side by side

Both are licensed in every state, both are graduate-entry professions, and both bill Medicare Part B as outpatient therapy. The differences that matter to a patient are in the first row; the ones that matter to a student or a biller are further down. If the comparison you came for is with chiropractic or athletic training instead, see PT vs chiropractor or athletic trainer vs PT.

One patient, two questions

Put a physical therapist and an occupational therapist in front of the same patient and they will both watch him get out of bed. The physical therapist is watching the movement: how he loads through the weaker leg, whether he needs his hands to push up, how many tries the sit-to-stand takes. The occupational therapist is watching the morning: whether he can reach his clothes, manage a button with one hand, and get to the kitchen with enough left in the tank to make breakfast without a fall.

That is the whole distinction, and it holds from the hospital ward to the outpatient clinic. Physical therapy restores a capacity — strength, range, balance, gait — and measures it. Occupational therapy restores a task, and is allowed to change the task to fit the person: a button hook, a raised toilet seat, a kitchen reorganised so the heavy pans live at waist height. A physical therapist rarely prescribes a tool when a capacity can still be trained; an occupational therapist will reach for one the moment the tool gets the person home sooner.

The PT asks how far you can walk. The OT asks what you need when you get there.

Where the two overlap

The overlap is real and it is mostly the arm. Shoulder, elbow, wrist and hand rehab is practised by both professions; a post-fracture wrist can land with either, and the measures are the same — goniometry against the upper-extremity norms and a self-report score like the QuickDASH. Hand therapy as a specialty draws from both.

Falls are the other shared ground, split down the middle. The physical therapist trains the balance and the leg strength; the occupational therapist walks the house and removes the rug, moves the commode and fixes the lighting on the stairs. A falls programme that gets only one of them gets half the intervention.

The overlap reaches the claim form too. Both disciplines can bill the same timed procedure codes — therapeutic activities is as much an OT code as a PT one — and the discipline is carried by the modifier on the line, not by the code itself. That matters for the Medicare meter below.

Where each one works

The two top-five employer lists share three entries outright and differ on the one that tells you most. Schools — educational services — employ 13% of occupational therapists and do not make the physical therapists’ top five at all. Paediatric and school-based practice is OT territory; outpatient orthopaedics leans PT.

Pay and outlook

The medians sit $2,430 apart, which is noise next to the spread inside each profession. Occupational therapists in schools earn a median of $87,300, against $106,300 in home health; the setting moves pay far more than the letters after your name. The bottom tenth of OTs earn under $71,690 and the top tenth over $131,950. The physical therapy side of the same picture, industry by industry, is in the physical therapist salary guide.

Occupational therapy is projected to grow faster — 15% against 12% over 2025–35 — but from a smaller base, so physical therapy still posts more openings a year. Either one is a much-faster-than-average occupation by the Bureau’s own label.

Getting in: the degree question

Physical therapy has one door: a Doctor of Physical Therapy (DPT) from a CAPTE-accredited program, typically 3 years, then the licensure exam. Occupational therapy has two. The entry-level degree can be a master’s or an OTD, and ACOTE states plainly that there is no mandate to move OT education to the doctoral level — each school chooses the master’s, the doctorate or both. A master’s program usually runs 2 to 3 years. Graduates sit the NBCOT certification exam, which carries the OTR title, and then apply for a state licence.

Medicare: two meters, not one

Medicare keeps occupational therapy on its own annual threshold — $2,480 in 2026 — while physical therapy and speech share a combined $2,480. A patient seeing both a PT and an OT in the same year runs two separate meters, and crossing one says nothing about the other. Past either amount the claim needs the KX modifier and documentation that the care is still medically necessary.

What routes a line to the right meter is the discipline modifier: GP for services delivered under an outpatient physical therapy plan of care, GO for services delivered under an outpatient occupational therapy plan of care. The evaluation codes are separate families too — the PT set is laid out in the evaluation code guide, and an OT evaluation never bills on it. And each discipline works under its own plan of care, which is exactly what the modifier attests to.

Which to ask for

Wage and outlook figures: BLS Occupational Outlook Handbook — Physical Therapists (May 2025 wage data), read 2026-10-18; BLS Occupational Outlook Handbook — Occupational Therapists (May 2025 wage data), read 2026-10-18. Scope of practice and licensure rules vary by state; check your own state board.