Members are discussing various aspects of nurse practitioner (NP) programs, salaries, and job satisfaction. Some members are sharing their personal experiences with NP programs and salaries, while others are referencing reports on NP salaries by state and specialty. Additionally, there is a conversation about the perception of certain cities and the impact of location on salary and job satisfaction.
Hi everyone. I'm curious as to see what an actual paycheck (before taxes) looks like from an NP. I find salary websites to be not very helpful. So...
What type NP are you?
Where (state)(rural/urban) do you practice?
Are you independent or in a group?
How many years experience?
What is your before tax paycheck amount?
Monthly or bi-weekly?
Salary/hourly/other(explain)?
Avg hours on check?
What are the perks of your contract? (ie. PTO/vacation/bonuses)
I know this is very personal, but if you are able to provide input, I would appreciate it! I'm mainly interested also to see after the gov/operational costs etc have taken their share, how much are you left with?
Actually, I do not have office space so my overhead is low. I go to various assisted living and skilled nursing facilities and take care of the residents. I just bill Medicare directly and use a billing company that charges 5% of gross.
So then do you pay for your office space or how does that work if you bill directly ?
Set up your corporation early. Depending on your state, you may need an S-Corp instead of an LLC. Make it a professional corporation. Get an accountant and a billing company set up. Get your own malpractice even if your employer offers it as a perk. Get credentialed on all insurance you want to accept. Setting it all up can take a while ,but in the end, you will make more than twice as much as a salaried NP, will be better able to help your patients, and will be content that you are being reimbursed for the positive outcomes you achieve, rather than allowing some physician to take pay for work you did.
Wow Madglee,
Those numbers are impressive. I know you're a psych np, but do you have any words of advice for a soon to be fnp grad?
I've always wanted to work for myself and never thought of being an independent contractor, but actually another np recently brought this to my attention.
Where (state)(rural/urban) do you practice? State that requires collaborating physician, rural
Are you independent or in a group? Private practice, specialty, with 3 other providers
How many years experience? Just graduated
What is your before tax paycheck amount? $3460
Monthly or bi-weekly? Biweekly
Salary/hourly/other(explain)? Salary
Avg hours on check? 72-80
What are the perks of your contract? (ie. PTO/vacation/bonuses) 5 wks vacation and 1 wk sick per yr, 7% bonus per year, $2500 for continuing education, and various other perks. No weekends, evenings, or holidays; no call
I find it interesting that some NPs are reporting higher than average incomes for MDs in their specialty.
Depends on region and competition. If you live in a saturated market you aren't going to be making as much. Goes for NP's and physicians. Similarly, lots of physicians are leaving family practice and new grads aren't even bothering because 150K a year isn't appealing when you make more in a specialty and have lots of student loan debt. Most NP's will take 3/4 of that in a hearbeat.
Where I live in El Paso, Texas, we have a very underserved community with really high demand for physicians and NP's. New jobs typically start at $90K and it's not uncommon to see NP's with a couple of years of experience pulling in over $125K a year. Meanwhile, several friends that graduated NP school and moved to Austin had to hustle to get a job out of school and in one case ended up take less than they were making as an RN. It's simple supply and demand. Choose to live in a saturated market, and make less.
Honestly, how can an np make $100 an hour if insurance will reimburse only $40 per visit? Ppl pay more for a haircut!
You realize most NP's, physicians, etc see more than one person an hour. A well run clinic with numerous treatment rooms can see dozens of patient in the course of an hour. Plus, that $40 is just for the visit not, additional care services that were provided. Lastly, lots of clinics advertise fee's for set services without needing insurance. A clinic I've precepted at advertises $60 flat fee a visit which includes assessment, treatment, and writing the prescriptions. Even patients with insurance often choose this route as it's less hassle.
I see an average of 3 pts an hour. If I would see more than that then pt care would be compromised. For every visit I bill there are 3-4 other people who have to get paid, not to mention the rest of our overhead costs. I find it fascinating that any np can take home anywhere near $100 per hour.
As to other services... There is a range for what insurance will pay, but some reimbursements are barely more than the cost of supplies. Example, we do allergy tests and the range of reimbursement is $80-300.
Well obviously if an NP is making $100 an hour they are an exception and not the common rule of thumb. That is over double the national average for NP pay.
That said, I'm sure we all know a few NP's that make a significant chunk of change. There is a group of NP's in my city that run two very success urgent care clinic's in town that are pulling in even more than $100 an hour or $200k. Specialty is also an important factor. The Psych NP's I know all typically make more than the FNP's. ACNP's are just starting to gain traction here but they too typically are employed by hospitals or intensivist groups and make more than clinic based FNP's. Most commonly you are going to find NP's, especially FNP's making $80-120K a year or roughly $40 to $60 an hour.
Specializes in ICU, CV-Thoracic Sx, Internal Medicine.
I see an average of 3 pts an hour. If I would see more than that then pt care would be compromised. For every visit I bill there are 3-4 other people who have to get paid, not to mention the rest of our overhead costs. I find it fascinating that any np can take home anywhere near $100 per hour.
As to other services... There is a range for what insurance will pay, but some reimbursements are barely more than the cost of supplies. Example, we do allergy tests and the range of reimbursement is $80-300.
I hear what you're saying Jeanette.
But there's a few things that need correcting.
1. Not all responders have overhead costs, i.e., clinic.
I for one see my patients at various inpatient facilities. They include hospitals, LTACH's, Acute rehab facilities and SNF's.
In these settings, there is no overhead for the provider.
But something to remember is the reimbursement can be less per E&M visit when compared to clinic E&M reimbursement.
2. As mentioned above, reimbursement in an outpt clinic is on average about 30-40% higher than that of an in-patient facility charge. If the bulk of your visits are level 1's and 2's then yes, you are billing at about an average of $40-50 per pt, but chances are your leaving money on the table and under billing.
I don't know the individual reimbursement per patient. I can see the summaries by CPT code at the end of the month and do the math. Maybe not everything is recorded in the system, and it doesn't take into account co-pays. Still, the reimbursements seem incredibly low. (Most of our visits are level 3-4 BTW, but we have a high percentage of Medicaid patients.)
DrZaphod, BSN, MSN, DNP, RN, NP
75 Posts
Actually, I do not have office space so my overhead is low. I go to various assisted living and skilled nursing facilities and take care of the residents. I just bill Medicare directly and use a billing company that charges 5% of gross.