Nurse Practitioner Salary (2026): NP Pay Guide for All 50 States

Board-certified nurse practitioners in the United States earn a national median of $136,864 per year — roughly $65.80/hour. NP pay sits in the top tier of U.S. nursing specialties and continues to climb, driven by physician-shortage gaps in primary care, the rapid expansion of psychiatric and addiction-medicine services, and the growing number of states granting NPs full practice authority.

The national median is only the middle of the distribution. Three numbers describe the real range of nurse practitioner compensation:

• Entry-level NPs (10th percentile): $104,836/year — typically newly board-certified FNPs or AGNPs in their first 1–2 years, often in family medicine, urgent care, or community health.
• Median NP (50th percentile): $136,864/year — the working NP with 3–8 years of practice as an FNP, AGPCNP, AGACNP, PNP, or WHNP, often in primary care, women's health, or hospital-based subspecialties.
• Top-earning NPs (90th percentile): $180,437/year — senior NPs in full-practice-authority states, psychiatric-mental health NPs (PMHNPs) running independent or telehealth practices, acute care NPs (AGACNPs) in hospital ICUs and ED fast-tracks, and dermatology, plastics, and aesthetics NPs whose roles include procedural revenue capture.

Geographic location matters, but population-focus specialty and state scope-of-practice often matter more. NPs in Sunnyvale, CA earn a median of $245,173, while colleagues in Pelham, AL earn around $100,192. PMHNPs and AGACNPs often out-earn FNPs by $25,000–$50,000 in the same metro. State Full Practice Authority (FPA) status, the local mix of physician-supervised versus independent NP practices, and demand from psychiatric and primary care underserved areas all push pay in measurable ways beyond cost of living.

Nurse Practitioner Salary vs FNP Salary — Are They the Same?

Mostly, with one important nuance. Nurse Practitioner is the umbrella occupational title; FNP (Family Nurse Practitioner) is one of six recognized population foci defined by the APRN Consensus Model. Every NP holds an RN license, completed an MSN or DNP from a CCNE- or ACEN-accredited program with a specific NP track, passed a national board exam — either from the American Academy of Nurse Practitioners Certification Board (AANP-CB) or the American Nurses Credentialing Center (ANCC) — and holds state APRN licensure with prescriptive authority. The six population foci are:

• FNP — Family Nurse Practitioner (across the lifespan)
• AGNP — Adult-Gerontology, in two flavors: AGPCNP (primary care) and AGACNP (acute care)
• PNP — Pediatric Nurse Practitioner (PC or AC)
• NNP — Neonatal Nurse Practitioner
• PMHNP — Psychiatric-Mental Health Nurse Practitioner (across the lifespan)
• WHNP — Women's Health Nurse Practitioner

All six reference SOC code 29-1171 in the Bureau of Labor Statistics Occupational Employment and Wage Statistics survey — the data source used throughout this site. Note that nurse anesthetists (CRNA, SOC 29-1151) and nurse midwives (CNM, SOC 29-1161) are tracked under separate SOC codes; this site reports NP pay only.

Hourly and Salary Pay Structures for NPs

Hospital-employed and large primary-care-group NPs typically receive an annual salary plus productivity bonus; urgent care, telehealth, and aesthetic-practice NPs more often work hourly or per-shift. The national median equivalent of $65.80/hour reflects a full-time 40-hour week, but specialty and structure drive wide variation:

• Primary care FNPs and AGPCNPs: $105,000–$130,000 base in most markets; total compensation including productivity bonus commonly $115,000–$150,000.
• PMHNPs: $130,000–$185,000+ in W2 roles; independent and telehealth PMHNPs in full-practice-authority states routinely clear $200,000 from contracted hours via platforms like Talkiatry, Headway, and SonderMind.
• AGACNPs in hospital medicine, ICU, and ED: $115,000–$160,000 base plus shift differentials and call pay.
• Dermatology, aesthetics, and plastics NPs: productivity bonuses on procedures (cosmetic injectables, laser, Mohs support) push total compensation past $180,000 in busy practices.
• NNPs in Level III/IV NICUs: $135,000–$175,000+ with strong call-coverage stipends.
• Urgent care NPs: often paid hourly ($55–85/hour) with weekend/evening differentials.

Total compensation typically includes CME stipends ($2,500–$5,000/year), license and DEA fee reimbursement, certification recertification cost, malpractice tail coverage, and 401(k) match on top of base pay.

2026 Nurse Practitioner Salary Projection

Nurse practitioner pay has grown at a compound annual rate of 3.45% over the past five years, driven by primary-care physician shortages, the rapid expansion of psychiatric and telehealth services, and the steady wave of states moving to full or reduced practice authority. The Bureau of Labor Statistics projects employment for Nurse Practitioners to grow 40%+ through 2033 — the fastest-growing healthcare occupation in the country — keeping strong upward pressure on wages, especially for PMHNPs and rural primary-care FNPs.

A PMHNP running a telehealth panel in a full-practice-authority state can earn nearly triple what an entry-level FNP in a restricted-authority state takes home. Four factors explain almost all of that gap: state Full Practice Authority, population focus and specialty, experience and certifications, and practice model.

1. State Full Practice Authority: The NP Pay Multiplier

The American Association of Nurse Practitioners classifies state scope-of-practice into three tiers. The classification is the single biggest non-specialty pay driver for NPs:

• Full Practice Authority (FPA) states — Arizona, Colorado, Idaho, Iowa, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, South Dakota, Utah, Vermont, Washington, Wyoming, plus DC and others — let NPs evaluate, diagnose, prescribe, and manage treatment without physician collaboration. Independent and telehealth practice is straightforward in FPA states, and reimbursement structures often flow directly to the NP.
• Reduced Practice states — require a collaborative agreement with a physician for one or more elements of practice, but allow significant autonomy.
• Restricted Practice states — California, Texas, Florida, Georgia, and others — require direct physician supervision or written collaborative agreements covering most clinical decisions. Restricted states pay competitive base salaries but limit the upside available from independent practice ownership.

FPA states routinely show NP medians 5–15% above similar-cost-of-living restricted states for the same specialty.

2. Population Focus and Specialty: PMHNP at the Top

Of the six APRN population foci, PMHNPs consistently earn the highest median pay, driven by a structural shortage of psychiatric prescribers and the rapid expansion of telehealth-based mental health care. AGACNPs in hospital ICUs and EDs and NNPs in Level III/IV NICUs follow closely. FNPs and AGPCNPs in primary care anchor the median; their broad scope and ubiquitous demand keep pay stable but cap the high end.

Within each population focus, sub-specialty matters:

• Cardiology, oncology, gastroenterology, and pulmonary subspecialty NPs earn 10–20% above primary-care peers.
• Aesthetic-medicine and dermatology NPs in cash-pay practices can clear $200,000+ in total compensation from procedural productivity.
• Urgent care, retail clinic (CVS MinuteClinic, Walgreens HealthHub), and telehealth NPs trade traditional structure for higher hourly rates and flexible scheduling.

3. Experience, Education Level, and Certifications

Entry-level NPs start at the 10th percentile — around $104,836 — and typically see meaningful raises within the first 2–4 years as they build clinical autonomy. The MSN-vs-DNP pay difference is modest in most clinical roles (a few thousand dollars) — DNP value is highest in leadership, academic, and policy roles. Subspecialty certifications (ENP — Emergency NP, CDCES — Diabetes Care, NCMP — Menopause, CWOCN — Wound/Ostomy/Continence, AOCNP — Oncology) carry $3,000–$10,000 pay differentials in their respective specialties.

4. Practice Model: W2 Employee vs 1099 Contractor vs Practice Owner

W2 hospital and group-employed NPs receive base salary plus benefits, retirement match, malpractice coverage, and CME stipends. 1099 contractor NPs — particularly PMHNPs on telehealth platforms (Headway, SonderMind, Talkiatry, Cerebral) — receive higher per-encounter pay but self-fund retirement, health insurance, and malpractice. Practice-owner NPs in FPA states can launch independent primary-care, psychiatry, aesthetic, or weight-loss clinics and capture full margin above overhead — top-quartile owners reach the 90th percentile and above. Locum tenens NPs work short contracts at premium rates ($90–145/hour all-in) for facility coverage gaps.

For a complete city-by-city breakdown of nurse practitioner salaries — including BLS percentile data (10th, 25th, 50th/median, 75th, 90th), local cost-of-living adjustments, and 2026 salary projections — browse the 1,684+ metro areas tracked in our dataset below.