Explore family medicine nurse practitioner and physician assistant salary ranges, hourly rates, and how locum tenens work changes earning potential.
Family medicine APP compensation is driven less by NP vs PA credentials and more by where and how you practice.
In 2026, most family medicine nurse practitioners and physician assistants earn between $130,000 and $145,000 annually, with higher earnings tied to practice setting, geography, and compensation structure rather than credential alone.
| Source | What it Measures | NP Compensation | PA Compensation |
|---|---|---|---|
| AANP (2024) | Average FNP salary | $129,976 | NA |
| Clinical Advisor (2025) | FM/IM/Primary care | $137,733 | $143,955 |
| AAPA (2025) | Median total compensation | NA | $134,000 |
| Medscape (2024) | Avg total compensation | $133,000 | $142,000 |
| BLS (May 2024) | Mean wage (all specialties) | ~$132K–$135K | ~$130K–$135K |
Three factors drive nearly all compensation differences:
1. Practice Setting
2. Geography
3. Compensation Structure
The gap between NPs and PAs is small. The gap between practice models is not. Clinicians who change settings often see larger income shifts than those who change roles.
| Compensation Type | NP Hourly | PA Hourly |
|---|---|---|
| W-2 (BLS average) | ~$62–$67/hour | ~$64–$70/hour |
| W-2 (specialty surveys) | ~$62–$68/hour | ~$68–$78/hour |
| Locum Tenens (typical) | $80–$110/hour | $85–$115/hour |
| Locum Tenens (premium) | $100–$120+ | $105–$125+ |
Hourly rate is where structure shows up. W-2 roles compress into a narrow band. Locum and 1099 roles expand it.
The highest-earning family medicine APPs are typically found in:
Facilities are not competing evenly for talent. Some markets have excess supply. Others are operating with persistent gaps. Compensation follows that imbalance.
Supply Growth
The Bureau of Labor Statistics estimates:
NP employment is projected to grow ~35% over the next decade, with PA growth around ~27–28%.
Demand Outlook
The Health Resources and Services Administration projects primary care will meet only ~76% of demand by 2038, indicating a long-term shortage.
Compensation Trend
Recent surveys show consistent upward movement in APP pay across primary care. Demand is growing faster than supply, sustaining upward pressure on compensation.
Locum work turns a fixed salary into a flexible income model.
For APPs, locum work is less about chasing the highest rate and more about controlling when, where, and how income is generated.
1099 APPs take on additional costs:
But they also gain advantages:
Career Trajectory
Compensation growth comes from changing settings and structures, not just accumulating experience.
The locum industry has a baseline problem. Smaller or less established agencies routinely cut corners that cost clinicians real time and real money: credentialing delays that push start dates, licensing gaps that leave clinicians exposed, malpractice coverage that turns out to be less than it looked, and invoices that drag on after the assignment ends. These are not edge cases. They are the baseline.
Barton Associates differentiates on three verified features:
Clinician-led clinical leadership.
Barton has a Chief Medical Officer and clinician-led oversight, bringing real-world clinical perspective into every placement.
Earned partnership for clinician financial life.
Barton partners with Earned, a wealth and tax firm built specifically for healthcare professionals, giving locum clinicians access to entity formation, tax planning, and long-term financial strategy.
Reflective-practice continuing medical education platform.
Barton operates a continuing education platform built around reflective practice on clinical work clinicians are already doing.
A reliable locum partner shows up in the moments when something goes wrong. Ask any agency how it handles a credentialing delay, a clinical concern at a site, or a mid-assignment malpractice question. The answer separates established partners from everything else.
Barton coordinates your job search from start to finish!
We’ll schedule a phone consultation to discuss your interests, goals, and work history to find the right opportunities.
Your Barton rep will submit your information to the facility you want to take an assignment at and work on next steps.
Barton handles licensing, credentialing, and travel arrangements before you arrive so you’re ready on day one.
Most earn between $130,000 and $140,000 annually depending on setting and geography.
Most earn between $134,000 and $145,000 annually.
PAs tend to earn slightly more, but the gap is small.
Yes. Locum APPs typically earn $80–$110 per hour, with higher rates in high-demand settings.
Yes. The Health Resources and Services Administration projects a long-term primary care shortage.
Rural, urgent care, correctional, and locum settings.
Tell us a bit about yourself to get started — we’ll match you with the right opportunities.
