NP Salary/Pay Let's Be Transparent

Transparency is important so we can negotiate. As a new grad nurse practitioner I accepted a ridiculously low paying position and I assumed that was the pay in the new city I move to. I have grown over the past couple years and I understand I was taken advantage of. I hope that this doesn't happen to others. Therefore, I believe it is critical we know what other nurse practitioners are being compensated so we are able to negotiate our salary and benefits packages.

I'm an FNP-C in Houston area working in Surgery (first assist, preop, and follow up post op care) Salary is 110k (negotiating to 115k), 3 weeks pto, 9 paid holidays, 1500 CME/yr, paid DEA, malpractice, 401k without match, 4 day work week (40-50hrs), on-call practically all the time (but only get calls on surgery days 2-3days/week). Overall I'm happy with the work I do.

What is your compensation package look like?

What Members Are Saying (AI-Generated Summary)

Members are discussing the salaries and job opportunities for nurse practitioners in different specialties, such as primary care and psychiatric mental health. Some members are comparing the pay differences between different NP specialties, while others are sharing their personal experiences and reasons for choosing a specific specialty. Overall, the discussion revolves around the factors influencing NP career choices, including salary, job satisfaction, and personal interest in a particular field.

179 Answers

I am wondering about the specialty, how are you feeling about surgery in the setting of FNP preparation?

As a new grad in Seattle I earned about $135K including incentive with 4 weeks PTO, $2K education, all license payment, on-call pay about 3-4 days per month, and quite flexible schedule, but for outcomes I worked about 50 hours/week.  Plus a lot of self-study as a new grad LOL.

I actually have quite a pay cut by choice in my current job.  It is my specialty of strength and choice.  Cost of living provides a similar financial outcome, and vacation about the same, which is most important to me.

Specializes in DNP, PMHNP, FNP-C.

Psych NP, private practice owner

Did 510k this year, finally broke the 500k mark after a few years.  Enforcing no show fees has been a game changer for me.  Granted I work M-F 10 hour days and didn't miss a single day of work this year with no vacation.  

The money is out there

Specializes in Dermatology.

12 years practicing, dermatology certified nurse practitioner

$230k base, bonus is 30% after revenues go above $750k, 35% after $1 million

This year practice will do $1.5 million in revenues.  Should net $480k

Doximity has a salary map that I've found helpful.  It provides est. compensation and average home price per county.  

I figured I would throw in a military perspective for an FNP. I returned to active duty Air Force. So there's a different breakdown compared to civilian. Bear in mind these numbers vary with location and nursing/NP experience. 

I came on as a NP with 3 years NP experience and 9 years RN experience prior which hit me the rack of 03/capt. 

base pay:4849.80/mo taxed to 3540.35

 housing allowance (non taxed based on location/higher with dependents) 2082/mo 

Monthly food allowance (not taxed):311.88/mo

speciality pay (all NPs have a specialty): 500/mo

 total take home: 6434.23/mo

 This is not including an accession bonus of $20000 for initial 3 year commitment or $30000 for initial 4 year commitment. 

After your initial commitment, you're looking at a retention bonus structure dependent on amount of years of your commitment and specialty (up to $36k/yr for 6 year option on FNP scale).

 My personal take home per paycheck is way more than when I finished as a civilian NP with a guaranteed 4 hours of weekly admin time and other patient load decrements based on actual military duties. 

Specializes in ICU nurse, general surgery nurse practitioner.

General surgery nurse practitioner with a first assist with about 2 year experience and an NP and 6 years experience as RN before. Located in upstate NY. When I first got hired I got offered $125k base, $10k yearly retention bonus, $1500 CME, 5.5 weeks of PTO, and some matching for 403B. I negotiated a raise last year and got my base up to $135k and made over $180k total last year including call pay. 
working hours are usually M-F 7a-5p. Call about 7 days/month but there is room to pick up more calls. 
job includes OR, inpatient, and some outpatient. 
I'm happy with my current job and compensation but I'm thinking about negotiating another raise

Specializes in Psychiatric and Mental Health NP (PMHNP).
djmatte said:

I'm not advocating for equal pay. I'm advocating for pay based on presumed value of the education level. If the reimbursement rates were the same then I would absolutely be advocating for equal pay. But even at 85% reimbursement, we're being paid 1/3 or less of the MD salary. We. Are. Being. Exploited. 

I agree some NPs are being exploited, but not all of them.  Honestly, I am paid very well.  After 3 years as a PMHNP, I'm making $100 per hour.  If I worked FT, that would be $208,000 per year.  That's good money, more than some doctors make, in fact.  Also, consider that a psychiatrist 3 years out of med school would be a resident making about $70K per year.  Right now, if I wanted to, even though I have not yet qualified for FPA in Calif, I could register with one of those online telehealth platforms that provide back office functions and funnel clients to PMHNPs, like Headway, etc., I could make $200K to $350K per year.  That is well in line with what most psychiatrists make who are employees.  A PMHNP posted somewhere on here recently that she did just that and worked 10 hours a day, 5 days a week, and cleared $500K in one year!  Once California NPs have FPA and can set up their own practice, they can charge what they want!

MentalKlarity posted they negotiated a very good deal with their employer and how they did it.  I forget the specifics, but it is a lot more than what I make.

I think an NP who is a good performer and has some solid experience can do these things.

Unfortunately, in parts of the country like the Southeast, NP pay is horrible and I don't know what they can do about that.  Although pay in the Southeast is bad across the board.  I read recently that Florida is now the most expensive state to live in when what people are paid is taken into account, because they are paid so poorly and the cost of living has skyrocketed there.

Also, doctors are not making as much as some on this board think.  In this post from KevinMD today, this pediatrician was only making $170K per year.  A lot of NPs make as much, or more, than that.  They provided some good tips on how to increase one's salary that NPs can use, too:

https://www.kevinmd.com/2023/09/unlocking-your-full-earning-potential-a-physicians-journey-to-a-70000-salary-boost.html

Also, for some perspective, as a PMHNP with 3 years of PMHNP experience, I still do not have as much experience as a psychiatrist still in their residency.  A new PMHNP has 600? (something like that) of clinical hours.  If they are lucky, they went through 1 year NP residency, but those are rare.  A "new" psychiatrist has the greater clinical hours in med school, plus 4-5 years of internship/residency and then usually 1-2 years of fellowship.  So right out of the gate, the new MD psychiatrist has 6-8 years more experience than a new grad PMHNP.  And those are very intensive years of experience.  Their education is also far more intensive than PMHNP education.  Just pick up a copy of one of their board review manuals if you don't believe me.

Even in the military, and I believe you are now in the military, doctors make more than NPs and PAs.  

https://www.thepalife.com/pa-vs-md-the-life-and-salary-of-a-military-trained-physician/

So, in summary, I agree some NPs are being financially exploited.  There have good tips on this board for those NPs to increase their pay.  Some of them may simply have to move to a state which pays NPs well, unfortunately.

However, I don't agree that NPs are subsidizing MD pay, at least in my experience.  In my practice, the med mgt providers are subsidizing talk therapist pay somewhat, and I am OK with that.  Also, MDs are not all making boatloads of money.

Finally, I just don't agree that NPs should make the same as MDs.  We don't have the same level of education and training.  It isn't feasible anyway, because the MDs would howl and cry so much - you can imagine.  It would also drive MDs out of certain specialties like psych.  The med students would choose specialties where MDs are guaranteed higher pay, like those in which they can perform various procedures that NPs can't.  At least in CA, we already have a shortage of primary care MDs and psychiatrists.

Personally, I'd like to see a path for NPs to become MDs in an accelerated manner, especially in specialties like primary care and psych that aren't that attractive to med students, anyway, and where there is an MD shortage.

If anyone is looking for an NP job in psych, PM me.

 

Specializes in ICU, trauma, neuro.

PMHNP graduated Oct 2019 working in the Seattle area on pace to earn around 250K three days per week seeing patients. No benefits 1099. Also I work from home and see clients only through telemedicine. My SO has been a PMHNP since 2016 and sees Medicaid patients (mostly few Medicare and private pay) in Arizona and earns $85.00/hr no benefits 1099 also working from home.

Specializes in psych/medical-surgical.

There are huge salary ranges depending on area of the country/patient population. Completely dependent on patient population and pay structure; many users and posts here discuss that. 

I did many interviews in different states: here in big TX cities - offers were around 120-140k (70$ an hour+ benefits). Offer in NM was a 50-50 split, so the provider would take around 100k if they generated 200k and the pt population was poor. In affluent areas like Seattle, NYC or CA, income can go up to 200k+ even with a 70% provider split if you are in private practice. DE there was an offer from 170-190k that was inpatient. In some other rural area of TX I think I had an offer at $50 an hour, inpatient/geri... which comes out to about 100k for full time work. The FNP who started her own concierge service in Austin, TX is easily making 200k+. I had an offer from a Psychiatrist in Austin as well and they did cash only, so you would probably at least make 150-200k+.

Specializes in Post Acute, Home, Inpatient, Hospice/Pall Care.

SE (Massachusetts suburb not city)
1.5 yrs NP, 10 yrs RN
Hospital based transitional care and mobile integrated health
I pick my own patients, work my own schedule and can work from home when needed.  I work on my own and only answer to one MD.
Salary $125,000
$5,000 bonus
4 weeks PTO
1 weeks CME + $5,000 CME
Full health benefit at manager level (but I don't need them)

FNP in the Bay Area/CA working in university setting in specialty practice. 
Salary 210k - no negotiations - based on union set rates/previous NP/RN exp.
2.5 weeks pto + separate sick time bank
All holidays paid 
1,500 CME/yr 1 week for education
Dea, malpractice included 
pension plan after 5 years 
Work 4 10 hr shifts, no call

I'm in rural PA. Brand new grad in a FQHC. $102,000. 40 hours a week. 4 weeks PTO, 1 week CME PTO. Full benefits. CME is only $1200 but increases every year until $4000 I think.

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