Physical Therapist in Billings, MT

The Salary Picture: Where Billings Stands

As a local, I can tell you that Billings offers a compelling financial proposition for Physical Therapists, especially when you factor in our low cost of living. The median salary for a Physical Therapist in Billings is $96,599 per year, which translates to an hourly rate of $46.44. This is slightly below the national average of $99,710, but don't let that number fool you. The real story is in what that money can buy in Montana's largest city.

When you break it down by experience, the progression in Billings is steady. While the 10-Year Job Growth for the metro area is projected at 14%—a solid number indicating sustained demand—local salaries reflect the practical realities of the Montana healthcare market.

Experience Level	Billings Annual Salary	Billings Hourly Rate	Notes
Entry-Level (0-2 yrs)	$78,000 - $85,000	$37.50 - $40.87	Often starts at hospital systems or large clinics.
Mid-Career (3-7 yrs)	$90,000 - $105,000	$43.27 - $50.48	$96,599 is the median, typically hitting this range.
Senior/Expert (8+ yrs)	$105,000 - $120,000+	$50.48 - $57.69+	Specialist certifications and leadership roles drive this.

Comparing to other Montana cities, Billings sits in a sweet spot. Bozeman and Missoula have higher costs of living, which can push nominal salaries higher, but often with less purchasing power. Billings, as a major medical hub for eastern Montana and northern Wyoming, offers a robust job market with 241 jobs in the metro area, providing more opportunities than smaller cities like Great Falls or Butte. The trade-off is a slightly lower nominal salary than the national average, but the financial breathing room you gain is significant.

The Real Take-Home: After Taxes and Rent

Let's get down to the nitty-gritty. With a median salary of $96,599, your take-home pay after estimated federal, state (MT has a progressive income tax), and FICA taxes will be roughly $6,500 - $7,000 per month. This is a conservative estimate that accounts for standard deductions and no additional dependents.

The average rent for a 1-bedroom apartment in Billings is $874 per month, a key factor in our affordability. Here’s a realistic monthly budget for a single Physical Therapist earning the median:

Category	Estimated Cost	Notes
Take-Home Pay	$6,750	After taxes on $96,599 salary
Rent (1BR)	$874	Citywide average
Utilities	$250	Includes gas, electric, internet
Groceries	$450
Car Payment/Insurance	$550	Essential, limited public transit
Health Insurance	$300	Employer-sponsored typical
Retirement (401k)	$400	4% match common
Misc/Entertainment	$500	Dining out, hobbies, etc.
Remaining Savings	$3,426	For emergency fund, travel, or investments

Can they afford to buy a home? Absolutely. The median home price in Billings hovers around $325,000. With a $3,426 monthly surplus, a 20% down payment ($65,000) is a realistic 2-year savings goal. After a down payment, a monthly mortgage, taxes, and insurance would likely be under $1,800, which is well within the budget. This is a stark contrast to markets like Bozeman, where the median home price often exceeds $600,000.

Where the Jobs Are: Billings's Major Employers

Billings is a healthcare powerhouse for the region. The job market is competitive but stable, with several major employers driving demand.

1. Billings Clinic: The largest independent, not-for-profit health system in Montana. They are the biggest employer in the region and constantly have openings across their outpatient clinics, inpatient rehab, and specialty care units. Insider Tip: They offer strong continuing education budgets and are known for promoting from within.
2. St. Vincent Healthcare: Part of the Intermountain Health system, a major player with a Level II trauma center. They have significant needs in orthopedics, sports medicine, and acute care. Their integration with the larger Intermountain network can open doors for career mobility.
3. SCL Health (now Intermountain) - St. John's: While the hospital is now Intermountain, the legacy system remains a key employer. They focus on a mix of inpatient and outpatient services, with a strong geriatric population base.
4. Therapy Solutions: A large, regional outpatient private practice with multiple locations. They specialize in orthopedics, sports rehab, and industrial rehab. They are known for a fast-paced, team-oriented environment and often hire new graduates.
5. Big Sky Medical Center: A long-term acute care hospital (LTACH) that provides a niche for PTs specializing in complex cases, ventilator weaning, and post-ICU rehab. It’s a great place to gain deep clinical expertise.
6. Billings Public Schools: The school district employs PTs for early intervention and school-based services. These positions are highly sought-after for their schedule (summers off) and focus on pediatric development.

Hiring Trends: There is steady demand for PTs with orthopedic and sports medicine experience. The aging population is driving growth in geriatric and home health settings. Telehealth is also growing, especially for follow-ups and rural outreach, a trend accelerated by post-pandemic changes.

Getting Licensed in MT

Montana's licensing process is straightforward but requires attention to detail. All regulations are managed by the Montana Board of Physical Therapy Examiners.

• Requirements: You must have graduated from a CAPTE-accredited DPT program, passed the NPTE (National Physical Therapy Examination), and completed a state jurisprudence exam.
• Costs: Total fees are approximately $350-$450. This includes the application fee ($150), jurisprudence exam fee ($100), and initial license fee ($200). You'll also need to factor in the cost of the NPTE itself.
• Timeline: The process typically takes 4-6 weeks from application submission to license issuance, assuming all documents (transcripts, NPTE scores) are in order. Insider Tip: Start your application before you have a job offer. Having an "active" Montana license on your resume makes you a much more attractive candidate to local employers.

Best Neighborhoods for Physical Therapists

Living in Billings is convenient. Most commutes are under 20 minutes, but neighborhoods offer distinct lifestyles.

• Downtown/Heights (West End): The trendy, walkable heart of the city. Close to breweries, restaurants, and the Alberta Bair Theater. Ideal for a younger, social professional. Commute: 5-10 minutes to Billings Clinic or St. Vincent. Avg. Rent 1BR: $950 - $1,200.
• South Side (South Park, Alkali Creek): Family-friendly, quiet, and close to the scenic Alkali Creek Trail. Popular with medical professionals who work at the major hospitals. Commute: 10-15 minutes. Avg. Rent 1BR: $800 - $1,000.
• West End (Near Hospital Hill): The epicenter of healthcare. Extremely convenient if you work at Billings Clinic or St. Vincent. More residential, less nightlife. Commute: 5 minutes. Avg. Rent 1BR: $750 - $1,000.
• Northwest (Shiloh Corridor): Modern, new developments, and close to retail (Target, Home Depot). A bit of a drive to downtown but easy highway access. Commute: 15-20 minutes. Avg. Rent 1BR: $900 - $1,100.
• Lockwood (East of Downtown): Growing area with more affordable housing and easy interstate access. A good option for those wanting more space. Commute: 10-15 minutes. Avg. Rent 1BR: $700 - $900.

The Long Game: Career Growth

A career as a PT in Billings can be very rewarding if you're strategic. The path to higher earnings involves specialization and leadership.

• Specialty Premiums: While formal pay scales are often confidential, earning a board-certified specialist credential (e.g., Orthopedic Clinical Specialist - OCS, Sports Clinical Specialist - SCS) can lead to a significant premium, often an additional 5-10% on base salary. This is crucial for moving into the $110,000+ range. Electrophysiology (EMG) certification is also highly valuable and can command a higher rate.
• Advancement Paths: The most common progression is from clinician to Clinic Director or Rehab Manager, which adds administrative and financial responsibilities (and pay). Another path is to move into home health, which often pays per visit and can be lucrative for efficient therapists. Billings also has a growing need for PTs in industrial rehab, working with local companies like Stillwater Mine or the oil and gas sector.
• 10-Year Outlook: With 14% job growth projected, new clinics will open, and existing ones will expand. The demand will be strong for PTs who can manage complex cases, work in niche settings (e.g., pelvic health, vestibular rehab), and embrace technology. The rise of value-based care will also favor PTs who can demonstrate excellent patient outcomes.

The Verdict: Is Billings Right for You?

Pros	Cons
Extremely Low Cost of Living – Your salary goes much further than in coastal cities.	Limited Cultural Diversity – Billings is predominantly white; it can feel homogeneous.
Strong, Stable Job Market – 241 jobs and 14% growth indicate opportunity.	Isolation – It's a 6-hour drive to a major city (Salt Lake or Denver).
Outdoor Recreation – World-class hiking, fishing, and skiing are in your backyard.	Weather – Winters are long and cold; summers are hot and dry.
Manageable Commutes – No traffic jams. Most commutes are under 20 minutes.	Limited Higher-Education Options – Few advanced degree programs locally.
Tight-Knit Medical Community – Networking is easier than in larger cities.	Air Quality – Summer inversions and wildfire smoke can be an issue.

Final Recommendation: Billings is an excellent choice for Physical Therapists who prioritize financial clarity, work-life balance, and outdoor access. It's ideal for those looking to buy a home, start a family, or pay off student loans aggressively without sacrificing a meaningful career. It may not be the best fit for those seeking a bustling, diverse metropolitan arts scene or who are sensitive to extreme weather. For the right person, Billings offers a high-quality, affordable life centered around a robust healthcare community.

FAQs

1. Is Billings a good place for a new graduate PT?
Yes, it can be. The cost of living is low, so you can manage student loans while gaining experience. Large employers like Billings Clinic and Therapy Solutions often have structured new graduate programs. The challenge is that the job market is competitive, so you should start your search early and consider applying for a license before graduation.

2. How do salaries in Billings compare to nearby cities like Bozeman?
While Bozeman might advertise a higher nominal salary (e.g., $105,000), the median 1BR rent in Bozeman can be $1,400+. Your purchasing power in Billings will almost certainly be greater. Billings offers a better balance for long-term financial health like homeownership.

3. What's the scene like for PTs specializing in sports medicine?
Growing, but competitive. With local teams (Billings Bulls, Mustangs) and a very active population, there's demand. However, many positions are within the major hospital systems or larger private practices. Breaking into this niche often requires an OCS or SCS credential and networking within the local sports community.

4. Are there opportunities for rural PT work near Billings?
Absolutely. Billings serves as a hub for eastern Montana and northern Wyoming. Many employers offer positions that include travel to smaller towns like Miles City, Hardin, or Sheridan, WY. These roles often come with a higher mileage reimbursement or a pay premium and are excellent for gaining diverse clinical experience.

5. What's the biggest challenge for PTs moving to Billings?
For many, it's the social adjustment. Billings is a great city for raising a family and building a career, but it doesn't have the nightlife or cultural scene of a major metropolitan area. It’s important to be someone who enjoys the outdoors and a slower pace of life. The medical community is friendly and supportive, which helps with the transition.