By Joe Dyton, WCI ContributorThere’s a certain curiosity about how much doctors earn, perhaps because physicians are believed to make sizable salaries. And it’s true they can earn a good living, depending on their specialty and where they work. But what about other healthcare workers? How much, for instance, can a nurse practitioner make?
Doctors don’t treat patients alone, and there can be curiosity about their colleagues’ salaries. And if they are curious, they’d learn that other medical professionals can also earn good salaries, including nurse practitioners (NPs).
What Is a Nurse Practitioner?
NPs are advanced practice registered nurses who have completed a master’s or doctoral degree program. NPs also have advanced clinical training that exceeds what they received to become a registered nurse. Their advanced training and skill set allows them to earn a higher salary—that and the growing demand for NPs. Keep reading to learn how much NPs make.
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Nurse Practitioner Average Salary
NPs earned an average annual salary of $111,000 (base) and $121,000 in total compensation, according to the 2023 Medscape APRN (Advanced Practice Registered Nurse) Compensation report. NPs' average salary was in line with clinical nurse specialists ($122,000 total compensation and $115,000 base salary) and nurse midwives ($122,000 total compensation/$114,000 base). Certified registered nurse anesthetists (CRNAs) out-earned the other three APRN specialties, however with an average salary of $235,000 in total compensation ($207,000 base).
Is Nurse Practitioners’ Income Rising?
NPs saw their income increase by 6% on average from the prior year, according to the Medscape report. Current market demand could lead to even greater pay bumps for NPs going forward — their profession is currently the fastest growing in the US, according to the Bureau of Labor Statistics.
The need for NPs is so great, in fact, that nursing schools are struggling to keep up with the demand to train them. The Department of Health and Human Services has announced awards of $100 million to help expand the nursing workforce. More than half of the awards will go toward advanced practice nurse training.
Do Nurse Practitioners Receive Incentive Bonuses?
NPs have opportunities to earn additional income. For example, some medical practices use an incentive-based pay model where NPs earn bonuses based on their performance. Bonuses could come from achieving various quality metrics or meeting patient satisfaction goals. Other practices may have a partnership or profit-sharing plan in place that allows NPs to take part in their practice’s earnings. The profit-sharing model provides NPs with a sense of ownership and investment in their practice.
Relative value unit (RVU) bonuses are one of the most common production-based models. RVUs are measurements assigned to many medical bill codes—when a practice performs a procedure, it equals a number of RVUs. NPs accumulate RVUs when they perform clinical services. Practices usually multiply those units by a set dollar amount—any earnings that exceed an NP’s salary are paid out as a bonus.
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Do Self-Employed Nurse Practitioners Make More Money?
Self-employed NPs can earn more money than their salaried counterparts—typically 10%-20% more. Self-employed (1099) NPs can earn more per hour than a W-2 employee because the former does not receive benefits from an employer. Contract NPs also have to pay self-employment taxes, which allows them to charge more for their services.
Additionally, a self-employed NP can increase their pay by lowering their tax obligations. Various business expenses can be written off to bring down your tax bill, including your cell phone, gas for your car, insurance, internet and other items you need to perform your job.
Meanwhile, between nurses paid hourly and those who earn an annual salary, hourly nurses earn more per year on average, according to Medscape ($154,000 vs. $139,000). The difference is due to hourly-paid nurses’ ability to earn overtime pay and clock their hours.
Do Nurse Practitioners Feel Fairly Compensated?
NPs were evenly split on Medscape’s question about being fairly compensated—50% said they felt that they were. This is an increase from the prior year’s report where 48% said yes but a drop from surveys before that—61% of NPs felt they were fairly compensated in 2021, for example. Additionally, more than half of the other APRN specialties said they were fairly compensated:
- Clinical Nurse Specialist: 54%
- Certified Registered Nurse Anesthetist: 68%
- Nurse Midwife: 55 %
“Generally, those APRNs who are paid based on their productivity—relative value units or bonuses — and perform well will view their compensation as fair,” Graig Straus, DNP, APRN, CEN told Medscape. “On the other hand, those with locked-in salaries and who are not given productivity incentives may complain about their pay.”
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What Are the Highest-Paid Nurse Practitioner Specialties?
NPs in the psychiatric-mental health field currently earn the most annually on average, according to Medscape ($134,000). NPs specializing in adult gerontology acute care are not far behind with an average annual salary of $132,000. Meanwhile, family NPs earn $124,000 annually.
“Overall, there’s a giant need for psychiatric care, and the lack of providers can warrant an increase in salary for those who provide this care,” Straus said. “This would be true for health networks hiring providers as well.”
Increasing Your Nurse Practitioner Income
One of the most important things that you can do to earn more for your work is to negotiate your pay and the terms of your contract. Many NPs wind up with bad contracts that leave them improperly compensated and facing high costs. If you’re negotiating a new contract, The White Coat Investor has a list of vetted attorneys and law firms to work with to make sure you get a good deal.
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