Industry Trends

NP salary report 2023: Pay increases but dissatisfaction persists

Graphic: Nurse Practitioner Salary Report 2023

Medscape’s 2023 Advanced Practice Registered Nurses (APRN) Compensation Report, which surveyed more than 2,800 advanced practice registered nurses, offers insights into nurse practitioner earnings, work environment, training, and supplemental incomes. Below, we’ve zeroed in on some NP salary trends for 2023.

NP salaries continue to increase

The salaries of nurse practitioners saw the most significant proportional pay increase among APRNs, at 6% on average above 2022 earnings. Earnings for NPs averaged $121,000, while salaried employees earned slightly more on average, $127,000.

APRN nurses working in hourly positions, which include locum tenens NPs, tend to earn more than their salaried counterparts because of overtime and the ability to choose how much they work. This year, APRNs reported earning an average of $139,000 as salaried employees, while hourly nurses earned an average of $154,000.

NPs working in hospital settings report highest incomes

Practice setting can impact your average compensation as an NP. Nurse practitioners who work in inpatient care in hospital settings reported the highest annual incomes at $139,000, followed by hospital-based outpatient settings or clinics at $128,000. Meanwhile, nurse practitioners working in medical offices or urgent care clinics outside hospital settings earned an average yearly income of $119,000.

NP income by practice setting

Chart - NP salary by setting in 2023

Education level no longer affects NP compensation

According to the survey, in 2022, an NP’s level of education had minimal impact on their earning potential. Nurse practitioners with either a master’s degree or a doctoral degree are likely to earn roughly the same annual salary. This finding differs from the prior two reports, which indicated an approximately 4% income difference between the two education levels.

NP income by highest degree

Chart - NP salary by education level in 2023

According to Greg Straus, DNP, APRN, CEN, this equalization in pay is justified. He says, “Having a Doctor of Nursing Practice or master’s does not change a nurse practitioner’s role or capabilities of practice.”

NP salaries vary by specialty

Among specialized nurse practitioners, those with psychiatric and mental health certifications commanded the highest salaries, with an average annual income of $134,000. This is owed in large part to the high demand for psychiatric mental health nurse practitioners for the past several years and to filling in for the shortage of providers with prescribing authority.

Coming in a close second are NPs with certifications in adult-gerontology acute care. They earn an average salary of $132,000, according to the survey.

NP income by specialty certification

Chart - NP pay by specialty

Family care practitioners are compensated the least of the specialty certifications available to nurse practitioners.

Gender disparities persist in NP compensation

Among NPs surveyed, male NPs continue to out-earn their female peers, who trail their male counterparts by an average salary of 12% less than males. Female NPs reported an average income of $125,000 compared to $140,000 in annual earnings for males, according to the survey.

Charla B. Johnson, DNP, RN, ONC, director of clinical information systems and nursing informatics for the Louisiana health system, commented: “Although the earning gap between genders is closing, the pace to parity is slow.”

NP salaries vary by region and community type

The report also studied APRN salaries by region. APRNs in the Pacific Region (Alaska, California, Hawaii, Oregon, and Washington) earned the most, while APRNs in the East South Central Region (Alabama, Kentucky, Mississippi, and Tennessee) earned the least.

APRNs practicing in the Pacific Region earned an average annual income of $159,000, compared with an average yearly income of $131,000 for the East-South Central Region. APRNs in the Mountain, New England, South Atlantic, West South Central, West North Central, and Mid-Atlantic regions each earned within $5,000 of each other (between $138,000 and $143,000). 

APRN income by region

The survey further explored the impact of community type on NP salaries and found that nurse practitioners in urban areas experienced a modest salary increase relative to suburban, exurban, and rural settings.

Nurse practitioners in urban settings earn $145,000 on average — roughly $4,000, $10,000, and $3,000 more than their suburban, exurban, and rural counterparts, respectively.

However, reported incomes were not adjusted for the cost of living, and housing, transportation, and food costs are important to consider. (For a look at cost-adjusted average NP wage by state, see these recent reports based on the U.S. Bureau of Labor Statistics occupational employment statistics survey: Nurse Journal and Becker’s Hospital Review).

One in two NPs earns supplemental income

Fifty percent of NP respondents earn supplemental income, including overtime or holiday shifts, charge nurse responsibilities, teaching classes, or acting as a preceptor. Thirteen percent of nurse practitioners surveyed say they have a second job or income-producing activity outside of nursing.

Of this 13%, many NPs work locum tenens, which affords them increased flexibility, higher pay, and greater work/life balance. NPs working locum tenens can choose how often they work, where they work, and what kind of practice setting they prefer. 

Find out if locums is right for you: 5 reasons why locum tenens makes sense for NPs

Only half of NPs feel fairly compensated

When asked whether they feel compensated fairly, 50% of nurse practitioners answered affirmatively — a slight climb from last year’s survey results, which was 48%. This proportion, however, has steadily declined over the previous few years (sitting at 53% and 61% in 2021 and 2020, respectively). In fact, nurse practitioners reported feeling compensated fairly at a lower rate than all other APRNs (including clinical nurse specialists, certified registered nurse anesthetists, and nurse midwives).

Do NPs feel fairly compensated?

Chart - NPs who feel fairly paid

Straus observes, “Generally, those APRNs who are paid based on their productivity — relative value units or bonuses — and perform well will view their compensation as fair. On the other hand, those with locked-in salaries and who are not given productivity incentives may complain about their pay.”

NP salaries grow, as does dissatisfaction with pay

Medscape’s most recent report on NP salaries shows continued growth in 2022, following trends from years prior. Nurse practitioners who are paid hourly, which includes locum tenens positions, earn more than their salaried counterparts. 

Despite financial gains, the challenges facing healthcare professionals continue to take an emotional toll on nurse practitioners and can lead to a feeling of not being compensated fairly. For nurse practitioners interested in increasing their income, the survey reveals that working in certain specialties, work settings, and geographical regions can positively impact NP salaries.

Are you interested in learning more about locum tenens for nurse practitioners? Give us a call or view today’s nurse practitioner job openings.

About the author

Alisa Tank

Alisa Tank is a content specialist at CHG Healthcare. She is passionate about making a difference in the lives of others. In her spare time, she enjoys hiking, road trips, and exploring Utah’s desert landscapes.