Duke Hand Center CHT, UNC burn OT specialty premium, WakeMed IRF, Fort Bragg military OT — and Mission Hospital Asheville HPSA shortage pay.
North Carolina has not enacted the OT Licensure Compact (OTLC) as of 2026. All travel OTs must obtain a full North Carolina OT license through the NC Occupational Therapy Licensure Board. Processing takes 6 to 10 weeks from receipt of a complete application.
NC's 4.5% flat income tax is one of the most competitive in the Southeast. Compared to graduated neighbors Virginia and South Carolina, the flat structure also eliminates bracket uncertainty as stipends and bonuses are added to total compensation.
| State | Top Income Tax Rate | Notes |
|---|---|---|
| North Carolina | 4.5% flat | Competitive flat rate — predictable take-home |
| Tennessee | 0% | No income tax — highest net pay |
| Florida | 0% | No income tax — strong SE alternative |
| Georgia | 5.49% flat | Neighbor state; slightly higher flat rate |
| South Carolina | 6.5% top | Graduated — higher top bracket than NC |
| Virginia | 5.75% top | Graduated — higher top bracket than NC |
Example: $2,600/wk NC OT Package (UNC Burn)
Typical structure: ~$1,000 taxable weekly wage + tax-free housing and meals stipend. NC state income tax on the $1,000 taxable base at 4.5% = approximately $45/week. Compare to Virginia at 5.75% ($57.50/week) or South Carolina top bracket at 6.5% ($65/week) — NC saves you $12 to $20 per week in state income tax vs. neighboring states.
Four demand drivers that make NC one of the Southeast's strongest travel OT markets.
Duke Hand Center is one of the premier hand surgery programs in the Southeast. Certified Hand Therapist (CHT) OTs are needed year-round for post-surgical rehabilitation: flexor tendon repairs, crush injuries, Dupuytren's contracture, scaphoid fractures, and TFCC repairs. CHT certification adds $100–$200/week to base pay.
The Chapel Hill Burn Center at UNC Medical Center is one of the few dedicated burn OT programs on the East Coast. Travel OTs manage escharotomy wound care, custom thermoplastic splinting, hydrotherapy, scar management, and pressure garment fitting. Burn OT is among the scarcest specialties nationwide — pay reaches $2,600–$3,100/wk.
Fort Bragg (Womack Army Medical Center) and Camp Lejeune (Naval Hospital) create sustained military OT demand: combat upper extremity injury, blast TBI ADL retraining, prosthetic training integration, and IDES medical evaluation board OT support. Military OT experience is valued and well-compensated at $2,200–$2,800/wk.
Charlotte, Asheville, and Wilmington are among the fastest-growing retirement destinations in the US. The resulting surge in Medicare-funded SNF and home health OT has created persistent travel demand in all three markets. Home health OTs with OASIS documentation experience are especially sought after across western NC retirement communities.
Where NC's highest-paying and most specialized travel OT assignments are concentrated.
Acute OT / hand surgery rehab / neuro OT / oncology
Level I trauma center. Duke Hand Center is the Southeast's premier hand surgery program — post-surgical OT for flexor tendon repairs, crush injuries, Dupuytren's contracture, scaphoid fractures. Neuro OT for stroke and TBI. Duke Orthopaedics. Lineberger Comprehensive Cancer Center oncology OT.
Burn OT / trauma OT / acute neuro OT
Level I trauma center. Chapel Hill Burn Center is one of the East Coast's dedicated burn OT programs: escharotomy, custom thermoplastic splinting, hydrotherapy OT, scar management, and pressure garment fitting. Acute neuro OT for stroke and TBI. High-acuity academic caseloads.
Acute OT / inpatient rehab OT
Largest Level I trauma center in NC by patient volume. Acute inpatient OT across a wide spectrum: trauma, ortho post-surgical, neuro, cardiac. Inpatient rehab OT for stroke, TBI, and ortho recovery. Charlotte metro growth creates additional outpatient volume across the Atrium system.
IRF OT — SCI ADL, TBI cognitive OT
Inpatient Rehabilitation Facility (IRF) serving the Research Triangle. SCI ADL retraining for cervical and thoracic injuries. TBI cognitive-functional OT. Stroke rehab OT. Research Triangle's growing tech and healthcare workforce creates sustained IRF demand.
Trauma OT / burn OT / mountain HPSA premium
Western NC regional referral center and the only Level II trauma center west of Charlotte. Mountain HPSA-designated shortage means 15–25% geographic premium over Piedmont rates. Burn OT, trauma OT, and general acute care. Asheville's retirement growth adds SNF and home health OT demand.
Military OT — combat UE, blast TBI, IDES
Womack Army Medical Center at Fort Bragg is the primary military OT hub in NC. Combat upper extremity injury rehabilitation, blast TBI ADL retraining, prosthetic training integration, and IDES medical evaluation board OT support. Cape Fear Valley augments with civilian trauma OT.
Weekly pay ranges reflect total package (taxable wages + tax-free housing and meals stipends) for a 13-week contract. Actual rates vary by facility, shift, and specialty certification.
| Setting | Weekly Pay Range | Demand | Notes |
|---|---|---|---|
| UNC Burn Center OT | $2,600–$3,100/wk | ⭐⭐⭐⭐⭐ | Specialty premium; escharotomy, scar, pressure garments |
| Duke Hand Center OT (CHT preferred) | $2,400–$3,000/wk | ⭐⭐⭐⭐⭐ | Year-round post-surgical hand rehab demand |
| WakeMed IRF OT | $2,300–$2,800/wk | ⭐⭐⭐⭐ | SCI ADL retraining, TBI cognitive OT, Raleigh |
| Military OT (Fort Bragg / Camp Lejeune) | $2,200–$2,800/wk | ⭐⭐⭐⭐ | Combat UE injury, blast TBI, IDES evaluations |
| Atrium / Acute Hospital OT | $2,200–$2,700/wk | ⭐⭐⭐⭐ | Charlotte Level I trauma, acute inpatient |
| Mountain HPSA OT (Asheville) | $2,400–$2,900/wk | ⭐⭐⭐⭐⭐ | Mission Hospital shortage premium |
| Outpatient Hand Therapy (OrthoCarolina) | $2,100–$2,700/wk | ⭐⭐⭐⭐ | CHT demand statewide; post-surgical ortho |
| SNF / Home Health OT | $1,900–$2,400/wk | ⭐⭐⭐⭐⭐ | Retirement surge — Charlotte, Asheville, Wilmington |
Updated every 4 hours from live assignment data.
New NC OT assignments posting daily
Our recruiters source NC OT positions directly — including unlisted Duke Hand Center, UNC, WakeMed, and Atrium contracts. Contact us to get first access.
Get NC OT JobsThe Chapel Hill Burn Center at UNC Medical Center is one of the only dedicated burn OT programs on the East Coast. Burn occupational therapy is among the rarest and most specialized OT skill sets in the country — which is why NC burn OT positions pay $2,600–$3,100 per week, commanding one of the highest premiums in the OT profession.
Travel OTs at UNC Burn Center manage a complex continuum of care from acute burn hospitalization through reconstructive recovery. The OT role spans wound care management, contracture prevention through positioning and splinting, functional mobility training, and long-term scar management. This is not a general acute care rotation — burn OT requires specialized training that most OTs never receive.
Pay: $2,600–$3,100/wk · License: NC OT Board licensure required (no compact) · Experience: Burn OT background strongly preferred; acute care OT minimum
North Carolina is home to two of the largest US military installations: Fort Bragg (now Fort Liberty) in Fayetteville and Marine Corps Base Camp Lejeune in Jacksonville. Together, these bases create one of the most unique travel OT markets in the country — focused on combat injury rehabilitation and military-specific OT evaluation services.
Womack Army Medical Center (WAMC) is the primary military OT hub at Fort Bragg. Travel OTs support the largest US Army installation by population, treating active duty soldiers with combat-related injuries, musculoskeletal repetitive stress injuries from training, and blast-related TBI.
Naval Hospital Camp Lejeune serves the Marine Corps Base and surrounding military community. Marine OT caseloads emphasize upper extremity injuries from combat operations and intensive physical training, plus OT evaluation services for Marines transitioning through the Integrated Disability Evaluation System (IDES).
Military OT Pay & Contract Notes
Military OT positions at Fort Bragg and Camp Lejeune pay $2,200–$2,800/week depending on setting (acute, outpatient, IRF) and specialty experience. Contracts are typically 13 to 26 weeks. Security clearance is not required for most OT positions, but contractors must pass a background check and may be subject to additional vetting at some installations.
Because North Carolina has not joined the OT Licensure Compact, every travel OT must obtain a full NC state license. The process is straightforward but requires planning: allow 10 to 12 weeks from submission to having a license in hand.
North Carolina has two of the strongest hand therapy OT markets in the Southeast: the Duke Hand Center in Durham and the OrthoCarolina statewide outpatient network. CHT-certified OTs are in sustained demand across both systems, and pay reflects the specialization premium.
$2,400–$3,000/wk — CHT preferred
Duke Hand Center is one of the Southeast's premier hand surgery programs, performing hundreds of complex upper extremity procedures annually. Travel OTs here manage post-surgical rehabilitation for the full spectrum of hand conditions.
$2,100–$2,700/wk — CHT demand
OrthoCarolina is the largest independent orthopaedic practice in NC, with locations across Charlotte, Raleigh, Winston-Salem, and beyond. Their outpatient hand therapy program is one of the busiest in the Southeast, driven by high orthopedic surgery volume from a growing active professional and retirement population.
CHT Certification & Pay Premium
Certified Hand Therapist (CHT) certification through the Hand Therapy Certification Commission (HTCC) typically adds $100–$200/week to base NC hand therapy OT pay. OTs without CHT certification are still hired for many hand therapy positions with appropriate post-surgical OT experience — but CHT-certified OTs get first access and higher compensation at Duke and OrthoCarolina.
No — not as of 2026. North Carolina has not yet enacted or implemented the OT Licensure Compact (OTLC). Every travel OT must obtain a separate North Carolina OT license through the NC Occupational Therapy Licensure Board. Processing typically takes 6 to 10 weeks. Apply as early as possible — ideally 10 to 12 weeks before your assignment start date.
The NC Occupational Therapy Licensure Board processes endorsement applications in approximately 6 to 10 weeks. You will need: current NBCOT OTR certification in good standing, verification of your primary state license, completion of the NC jurisprudence exam (online), and the application fee (approximately $150). Submit your completed application at least 10 to 12 weeks before your contract start date to avoid delays.
Travel OT pay at Duke University Medical Center ranges from $2,400 to $3,000 per week depending on specialty — Duke Hand Center CHT positions command the higher end. UNC Medical Center burn OT positions pay $2,600 to $3,100 per week due to the specialty premium for burn OT, which is one of the scarcest OT specialties nationwide. Pay varies by shift, experience, and contract length.
North Carolina has a 4.5% flat income tax rate — one of the most competitive in the Southeast after no-tax states like Tennessee and Florida. On a typical travel OT package with a $1,000 taxable weekly wage base, NC state income tax is approximately $45 per week. This is substantially better than Virginia (up to 5.75%) or South Carolina (up to 6.5%). The flat structure means no bracket surprises as your income grows.
The Chapel Hill Burn Center at UNC Medical Center is one of the few dedicated burn OT programs on the East Coast. Burn OT requires specialized skills that most OTs never develop: escharotomy wound care management, custom thermoplastic splint fabrication for contracture prevention, hydrotherapy OT protocols, scar management using silicone gel sheets, and custom pressure garment fitting for hypertrophic scarring. These skills are in extreme shortage nationally, which is why burn OT positions pay $2,600 to $3,100 per week.
Duke Hand Center, UNC burn OT specialty, WakeMed IRF, Fort Bragg military OT, and Mission Asheville HPSA premium — our recruiters place travel OTs across every NC market.
$2,300–$3,100/wk · 4.5% flat tax · Duke Hand Center · UNC Burn · WakeMed IRF · Fort Bragg Military OT
