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?

Specializes in Physical Medicine & Rehabilitation.

@SkinD8P
I do recall seeing an admin post somewhere that you need a certain total number of posts (I think it's like 5 or 10) before you have access to Private Message someone.

New NP here that recently started. I am a sub contractor and I do home visits (tele, and soon to be office visits) for annual wellness exams. I get paid per patient, $125 (with a few $$$ here and there if I do additional exams like a spirometry, etc) for home visits and $90 for tele. No benefits at all. I get my schedule confirmed the afternoon-night before. If I need time off, I just tell my schedule what days I need off. I think I got real lucky finding this gig. Next week, I'll be doing C&P Exam appointments for the VA for $100/hr 2/week then doing the wellness visits the remainder of the week. A bit nervous about being a C&P examiner, so we'll see how it goes.

Specializes in Psychiatry.
FullGlass said:

You have made many posts about earnings and telling other NPs they are not making enough.  Please share information on your employment situation and how much you make.

Psychiatry, a 75-25 split with my employer, which works out to be about $250-$300 per hour on average. 6 weeks paid vacation (paid at $200 an hour) and additional 4 weeks unpaid vacation. 

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 Physical Medicine & Rehabilitation.

^ I too have see that link in reddit. The site looks kinda legit, but there were comments about how it was asking for full name, phone number, etc. I went to post my salary on that site but did not feel comfortable posting any of my info.

I thought I posted my salary in this thread but I guess not. Here it is!

Full time rehab NP in the SNF setting here in Southern California.

  • Salaried - 126k; started off as a new grad. Pending to be changed to per patient ratio soon
  • On paper, 5 days a week, 40 hours/week, see about 120 patients per week
    • More accurately, 4 days a week, ~ 20-25 hours/week, see about 110-130 patients per week (you make your own schedule)
  • Experience - Will be hitting 1 year with this employer and PM&R specialty (rehab/pain mgt) next week. Total NP experience is 2.5 years
  • 15 days PTO per year; sick, bereavement, and PTO all combined
  • 1500/year reimbursement for CME, license, and DEA renewal
  • Mal practice coverage provided
  • 401k plan
  • Health insurance provided/covered

I also work a per diem, 1099 contracting job with an s-corp as a medical examiner for a DNP (we have a contract with the VA).

  • On paper 4-6 hours, 1 day per week either on Saturday or Sunday
  • Paid per chart/appointment in which pay is 40, 50, 75, etc per chart depending on the circumstances. But for the sake of averageness, it's about 2-3k per month
  • No benefits whatsoever
  • Self scheduling - you provide your days/hourly availability and they will try and schedule appointments. Sometimes inconsistent, but that's a story for another time
  • Had no experience prior to starting, none was required. Been with this doc for almost 2 years now.

 

 

4 days a week 115k a year as a new grad!?!! 
most will say that's a good gig 

I mean Great  gig

Specializes in psych/medical-surgical.

As someone pointed out, there are a lot of factors that come into play and there are a lot of threads about this here already. Location is huge.

It's way more complex than most of what you see here though; in independent practice, you can negotiate everything. For instance, as a PLLC you can negotiate reimbursement rates. If you have a good relationship with a physician, you don't have to pay that much. You can also choose certain insurances after you build clients that pay more... etc.

TLDR; depending on how hard you advocate for yourself, your salary will be way off the average. I don't know if this applies in something like primary care as there are obvious differences.

Specializes in FNP.

Primary care, 40 hours, 150k after bonus, 5k CME, 150 hours PTO not including about 8 holidays, 5 yrs experience, Texas. Lots of opportunities for OT, but would rather spend time with the family.  

Just left my last job after having a baby but here it is:

New grad PMHNP in the South with previous psych RN experience

  • $86k
  • 8-5pm weekdays
  • No paid holidays
  • No CME
  • No bonuses
  • Had to pay 90 dollars every month for parking

Yeah it was pretty bad. It was in the South where there were 2 PA schools in the area and 1 NP school, so the competition was pretty fierce. What made matters worse was the psychiatry facility I worked for was mostly hiring PAs in psychiatry and didn't think much about me having a psych certification as an NP, it was outpatient and I was actually replacing a PA. When I got my supervision agreement they wrote for me they initially wrote FNP as my credentials, in fact I had a psychiatrist ask if I could even prescribe medication on an interview! 

I now am about to start a new position making $70 per hour, seeing 1 patient an hour (doing med management and therapy) much better arrangement!

Specializes in Pulm.

I do pulmonology in Idaho in a medium size town. I see between 8-12 patients a day. Starting offered salary was 95K with an adjustment up to 103K based on 2 years experience as an NP. I have been in my current practice two years and make $110k with a yearly 10% bonus. I get 8 hours PTO per pay period. I work 8:30- 4:30 mon thru Thursday and 1/2 day Friday.

Specializes in ICU, trauma, neuro.
2 minutes ago, irvine123 said:

NP pay is way better in Texas and the midwest than in California, thats for sure.

NP pay in California is some of the best in the nation. Now the cost of living and taxes are less than optimal in many places, but not so bad in others (Bakersville, Sacramento for example.).

Specializes in ICU, trauma, neuro.
14 hours ago, irvine123 said:

I should mention when compared to cost of living, its on the low end.

If you like California or Texas then Arizona or Nevada might be worth considering since they both have IP for NP's and lower cost of living (than California).    Nevada has the added bonus (like Texas) of no state income tax.  Not to mention being able to go for some decent food a 0300 in the morning if that is your thing.

+ Join the Discussion