As for the highest paying field within OT? Well now, that really all depends on if you're talking strictly clinical or no - as outlined above, there are different rules that apply to payment when it comes to clinical vs. management. Considering that many of you are still plugging away at your degree, I'll make the assumption that this question is geared clinically since management positions are generally out of reach for new grads until you reach certain experience criterion.
I've worked practically everywhere. I started in acute inpatient hospital, did psych on the side; I did outpatient othro/neuro; I did so many subacute jobs that I honestly cannot count how many SNFs I've graced; I've worked pediatrics and autism; I've worked acute rehab; I've worked home therapy; I did a little bit of educating; presently, and what I've come to love and specialize in is upper extremity pain management (cervical and thoracic spine, shoulder, arm, hand) as a myofasical pain specialist working in hands. Out of allllllll of those (excluding management titles)...
- SNFs generally pay very well. Prepare to work your butt off though to meet borderline unrealistic productivity standards. (anywhere between 70-80K starting)
- Home Health (especially PRN pools) pay a lot of money. A established hospital system in MD will pay their home health OTs $90 per eval and $75 per treatment. I hope you have a good car! (depends on caseloads, but a clever therapist can clean up if they're lucky)
- Outpatient is a mixed bag. The pay is not so great if you work through a hospital system. Its fantastic if you find a private clinic (which is where I am now, where I earn roughly $125,000 but keep in mind that I am management and clinical; starts between 60-70K)
- Acute inpatient hospital is AWESOME as a first job (you will learn so much that you will skyrocket beyond your peers) but the money is not particularly great (starts at 55K).
- Pediatrics just doesn't pay well unless you own a clinic for it. Historically, its the lowest paying option. (I've seen starts at 45k).
- Hand therapy takes 5 years of experience , lots of documentation to support that fact, and a spiritually trying certification exam. It does pay well (starting, at lowest I've ever seen, 85k. It usually is much more than that).
In any field, hard work and consistency will eventually net you more money. The money will come with time, but I assure you that experience and confidence is what will set you apart...and will be the decisive factor in achieving the universal dream of six figures.
EDIT: Just keep in mind that the figures I posted for starting are just that - they're low ball starting figures that generally indicate the lowest you should expect to be paid as a new grad. Many times, you may be paid more than that; you should not accept a job that offers you lower than the figures I posted to be brutally forward.