5 Factors That Contribute to Per Diem PT and OT Pay Rates

What can you expect to be paid as a per diem physical therapist or occupational therapist? You already know the answer, it depends. But what does it depend on? Location and setting mostly seem to dictate pay rates. Experience may not be as much as a factor as one would expect.

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1. Setting

Generally speaking, per diem pay rates for occupational and physical therapists in home health and skilled nursing facilities are on the higher end of the spectrum, with acute care and private practice outpatient being on the lower end. Hospital based outpatient is likely to be higher than private practice, and there may be a difference between smaller private practice clinics and larger big box type clinics.

2. Location


You might think rural locations would have lower pay than a large city. Sometimes the opposite is true. A rural location may have higher pay rates because they have difficulty finding therapists and therefore, an incentive to pay more. On the other hand, a popular city may have lower pay rates because it is a desirable place to live.

3. Experience


It would seem that with more experience would come more money. This isn’t always the case in the therapy world. You may hear that the reason for this is because the reimbursement for therapy services is the same regardless of the experience level of the provider.

This seems to be the case with some companies that staff SNFs. They may simply offer a flat rate of pay, regardless of experience. However, hospital systems often have some type of pay scale based on the number of years you have been practicing.

4. Lack of Benefits

As a per diem PT or OT, you should expect a higher hourly pay rate than a full time employee in the same position. This might be a dollar amount or a percentage of your hourly rate. A pay package for a full time employee often includes PTO, health insurance and some contribution to a retirement account. The differential is offered to per diem employees because the employer is typically not paying for these things for you.

In my personal experience, however, at least 2 of the large hospital systems I’ve worked for did offer matching retirement contributions for per diem employees. To receive a match, the employee was required to work at least 1000 hours per year. I’m not sure about the third as I’ve never come close to working that many hours for them.

5. The Ability to Negotiate

Is there room to negotiate? Possibly. Personally, I have not had much success with the flat per diem PT rates offered by SNFs or the pay scale rates offered by the hospital systems that I've worked for. I don’t have much experience with private practice outpatient or private practice home health, but I have read anecdotal success stories from various groups on the internet. So, as the saying goes, you don’t get if you don’t ask. Who knows, you may even have success with the settings that I did not.

Where Can You Find Actual Numbers?

Pay transparency has become a popular topic recently. I definitely remember a time when I was essentially told I was not allowed to discuss pay. It’s less taboo now, and actually a federal law prohibits an employer from prohibiting you from talking about pay with coworkers or retaliating against you if you do.

This does’t mean everyone now feels comfortable sharing, especially in person. But some therapists have been working on collecting PT and OT pay rates, including some per diem information. Most of it is self reported, and not all encompassing, but these are some good places to get started on your search for what to expect.

DPT Steph - geared toward new grads

Home Health Chronicles - some per diem pay rates included

OT Salary - for OT's

UpDoc Media - a downloadable full salary report