Psychiatric nurse practitioner salary in 2026 — pay by state, setting and experience, and the maths behind the offer

What psychiatric nurse practitioners earn in 2026

Start with the only number that comes from a government survey of employers rather than from self-reported profiles or job adverts. The Bureau of Labor Statistics put the median wage for nurse practitioners at $132,300 a year, or $63.61 an hour, in May 2025.¹ That figure covers every NP specialty, and the full distribution is worth more than the median on its own.²

The mean is $137,300, pulled above the median by the top of the distribution.² Those figures are base wages reported by employers, so they exclude bonuses, shift differentials and the value of benefits. They also exclude the self-employed, which matters for a specialty where a meaningful share of clinicians work on 1099 contracts.

Every PMHNP-specific figure sits above the all-NP median, which is the pattern you would expect in a shortage specialty. ZipRecruiter's PMHNP average was $139,486 ($67.06 an hour) in September 2026, with the 90th percentile at $197,000.³ The AANP's national compensation survey, as reported by Barton Associates, put the median total income of full-time PMHNPs at $145,000.⁸ And a tracker that scrapes advertised ranges from live postings found a median of $166,000 across 434 listings with disclosed pay in October 2026, with the middle half running from $130,000 to $225,000.⁹

Here is what that last number hides. Advertised ranges are the ceiling an employer is willing to print, not what the person who takes the job is paid, and listings that disclose pay skew towards the employers who have something to show — telehealth platforms and high-cost states. Treat $166,000 as what the market is asking for, $132,300 as what the average NP of any specialty actually receives, and the gap between them as the room you have to negotiate.

Why there is no official PMHNP salary

The BLS classifies nurse practitioners under a single occupational code, 29-1171, and does not split it by specialty.² There is no code for psychiatric-mental health nurse practitioners, which means no official median, no official state table and no official setting breakdown for the job you actually do. Every page claiming a "BLS PMHNP salary" is showing you the all-NP figure with a different label.

What the BLS does publish, and what this article leans on, is the NP wage by state and by industry. A psychiatric NP working in an outpatient mental health centre falls under outpatient care centres; one in a psychiatric hospital falls under hospitals; one in a group psychiatry practice falls under physicians' offices. Those industry figures are real, just not psychiatry-specific.

For the PMHNP-specific layer, the choices are: the AANP's member survey (the largest self-reported dataset, but the specialty tables sit inside a paid report and reach the public second-hand); Medscape's annual APRN survey (1,543 NPs in the 2025 edition, with breakdowns by employer type and pay structure but not by psychiatric specialty);⁷ and the job boards, each of which measures something different. The next section is about that.

What each job-board figure actually measures

Search "psych NP salary" and you will see numbers from $99,000 to $166,000 presented with equal confidence. They are not contradicting each other so much as measuring different things.³⁵⁶⁷⁸⁹

Three things to notice. Payscale's figure is low because it is base salary from a small, self-selected sample that skews early-career; its total-pay ceiling of $145,000 is closer to the other sources. Salary.com models base pay only, and its own FAQ on the same page quotes a different PMHNP median of $130,130 — a reminder that these tools are estimates with wide error bars.⁵ And the tracker's $166,000 is a midpoint of advertised ranges, which overstates what is typically paid in the same way that "up to" overstates a sale price.

When an employer or recruiter quotes "market rate" at you, ask which of these they mean. The honest centre of the evidence for a full-time, W-2, experienced PMHNP in 2026 is roughly $135,000 to $150,000 in base, with total compensation above that in hospital systems and well above it on contract.

Psychiatric nurse practitioner salary by state

State is the single largest factor the federal data can measure. On BLS figures the NP median runs from $168,520 in California to $105,750 in Alabama, a gap of nearly $63,000 before cost of living.² The table below pairs that official NP figure with two PMHNP-specific estimates: ZipRecruiter's modelled average and, where there were enough postings to be meaningful, the median advertised range from live PMHNP listings.²⁴⁹

Read the three columns against each other rather than picking one. Where the official NP figure and the PMHNP estimate agree — Washington, New York, Alaska — you can be fairly confident of the market. Where they diverge sharply, the divergence is itself information. California's BLS median is the highest in the country, yet ZipRecruiter's PMHNP model puts it mid-table and the advertised median is $225,000: that is a state where hospital-system NPs are paid very well, where cash-pay private practice is large, and where the modelled average is dragged down by lower-cost inland markets. Florida's $104,237 on ZipRecruiter against a $129,510 BLS median says the opposite — a market with a lot of low-paying postings pulling the model down.

Small samples in the advertised column deserve scepticism. Ohio's $223,000 median rests on 11 postings and Oregon's is omitted because the tracker had nine; a single telehealth platform advertising a wide range can move those numbers by tens of thousands.⁹ The BLS state figures, by contrast, are built on thousands of employer returns per state and are the ones to anchor a negotiation on.

Finally, nominal pay is not purchasing power. A $133,390 median in Oklahoma buys considerably more than $153,510 in New York, and the states with the highest raw figures are, without exception, the states with the highest housing costs. Where the openings actually are by state and metro, and what licensing takes in each, is covered in the PMHNP jobs guide.

PMHNP salary by setting

The BLS publishes NP wages by industry, and the Medscape and PMHNP Hiring data add employer-type and setting layers. None of it is clean, so the table below is explicit about which source each row comes from.^17891112

A few settings do not appear in any dataset and deserve a plain statement.

• Community mental health centres. Folded into outpatient care centres in the BLS data, which flatters them: the outpatient median is lifted by hospital-owned clinics and surgical centres. CMHC base pay commonly sits below the private-practice figures in the same city, offset by loan repayment eligibility (National Health Service Corps sites) and a predictable schedule.
• Corrections. No reliable national figure exists for PMHNPs in jails and prisons. State and federal correctional roles are posted on public pay scales and, because of recruitment difficulty, often carry shift and hazard differentials. Check the state's posted range rather than any salary aggregator.
• The VA. VA nurse practitioners are paid on the Title 38 nurse scale with locality adjustments, which is why a single posting can show a range nearly $90,000 wide.¹² The range is real: where you land depends on a professional standards board's grading of your experience. Pension, the federal retirement match and the Education Debt Reduction Program (up to $200,000 over five years for qualifying positions) are the reasons the base can look ordinary and the package can still win.¹²
• Private practice, owned. No survey separates owner-PMHNPs from employed ones. The Medscape "private NP practice" figure of $131,000 is for employees, not owners, and should not be read as the ceiling of self-employment.⁷

The pattern that holds across every source: settings that pay per hour or per unit of work (contract, locum, telehealth with volume pay) show higher gross figures than settings that pay a salary, and the gap narrows sharply once benefits and unpaid time are counted. That is the subject of the maths section further down.

PMHNP salary by experience

Experience moves PMHNP pay less than you might expect, and far less than state or pay structure. The two datasets that break it out disagree on the size of the effect.⁵⁷

Salary.com's model shows a spread of under $5,000 between a new graduate and a PMHNP with eight-plus years, which is implausibly flat and reflects the limits of modelling base salary from employer data.⁵ Medscape's self-reported total compensation shows a more believable curve — around $13,000 from mid-career to late-career — but it is for all NPs and it flattens completely after year 20.⁷

The honest reading is this. Your first PMHNP role will typically be offered in the $110,000 to $130,000 band on a W-2, and the sources agree that the band narrows rather than widens with time in the same setting. The large jumps in PMHNP income come from changes of structure, not from anniversaries: moving to a hospital system, taking a productivity contract, adding 1099 telehealth hours, or opening a practice. The $174,420 90th-percentile NP wage is reached by people who changed how they are paid, not by people who waited.² The path into the role itself, including programme costs and the certification exam, is in how to become a PMHNP.

Does full practice authority raise pay?

Not directly, and the state table above is the evidence. The AANP classifies each state's NP practice environment as full, reduced or restricted, and updated its map in May 2026.¹⁵ The three highest-paying states on BLS data are California (restricted, with a transition route to independence), New Jersey (reduced, changing in 2026) and Washington (full). Alaska, Oregon and New York are full-practice states with medians above $150,000; Texas is restricted and sits at the national median; Alabama is reduced and sits at the bottom. Practice authority does not explain the ranking.

What it does change is where the money can come from.

• In a restricted or reduced state, someone pays for a collaborating physician. Independent collaboration arrangements cost roughly $300 to $2,500 a month in most markets, with psychiatry towards the top of that range.¹⁶ If the employer carries it, that cost is built into what they can offer you. If a 1099 contract expects you to find and fund your own, it is a pay deduction of up to $30,000 a year that the advertised hourly rate does not show.
• In a full-practice state, private practice is a realistic option, and the existence of that option is itself leverage in a salaried negotiation. An employer in Washington is bidding against the possibility that you open your own panel; one in Texas is not.
• Telehealth contracts follow the patient's state. A 1099 telepsychiatry platform paying the same rate in every state is paying you less in a restricted state once the collaboration requirement is accounted for — or is quietly carrying that cost itself and recovering it from the rate. Ask which. The licensing and controlled-substance rules for multi-state telehealth are in the remote PMHNP jobs guide.

No peer-reviewed study we could verify puts a current dollar figure on the full-practice-authority premium for PMHNPs specifically. Anyone quoting one is extrapolating.

The 1099, locum and telehealth maths

This is where most PMHNP pay comparisons go wrong, because hourly contract rates and annual salaries are not the same currency. An advertised $95 an hour looks like nearly $200,000 a year. It is not, and the reasons are arithmetic rather than opinion.

Start from what the market actually offers. Agency locum PMHNP placements ran $71 to $100 an hour over the twelve months to March 2026, averaging $95, with housing and meal reimbursements on top for travel assignments.¹¹ ZipRecruiter's 2025 locum figure, as cited by Barton, was higher at $139 an hour, with a 25th-to-75th range of $93 to $192.⁸ W-2 telepsychiatry platform roles average around $63 an hour.⁸ General 1099 telehealth contracts are advertised at $75 to $150+ an hour against W-2 equivalents of $55 to $100.¹⁰

Now convert a W-2 salary into the 1099 hourly rate that would merely match it. Take a $140,000 salaried role with ordinary benefits and the inputs that the 1099-versus-W-2 comparison in the PMHNP Hiring guide uses — employer-paid health insurance worth several thousand dollars, a 4% retirement match, four weeks of paid leave, employer-paid malpractice and the employer's half of payroll tax.¹⁰

The figures in that table are illustrative arithmetic built on the published inputs, not a survey result, and your own numbers will differ. The point survives any reasonable change of assumptions: a 1099 rate has to be about 25 to 30% higher than the W-2 hourly equivalent before it is a raise, and that is before the 1099 clinician absorbs no-shows, unpaid documentation time and the gaps between contracts. The PMHNP Hiring worked example reaches the same conclusion from the other direction — a $200,000 gross 1099 position nets out at roughly $119,500 of comparable value against roughly $133,000 for a $160,000 W-2 role, before the contractor's retirement deductions narrow the gap.¹⁰

Three refinements the simple version misses.

1. Per-visit telehealth pay is hourly pay with the no-shows transferred to you. A platform paying per completed visit at a rate that implies $90 an hour on a full schedule pays $63 an hour at a 70% show rate. Ask for the platform's actual completed-visit rate for current clinicians, not the target, and price your hour on it.
2. Locum travel assignments include things that are not pay. Housing, per diem and travel reimbursements are real money but they are not taxable income and do not compound into retirement contributions; the $95 average above already blends some of those in.¹¹ Strip them out before comparing with a salary. Contract structure, tax-home rules and what to insist on are in the travel and locum PMHNP guide.
3. At high volume, 1099 does win. The crossover sits around $250,000 of gross contract income, where the self-employed retirement limits and the qualified business income deduction start to outweigh the lost benefits.¹⁰ Below that, the 1099 premium is mostly paying you to carry risk.

The same rate arithmetic for a different profession, with the 1099 risk list in full, is in 1099 or salaried: the rate math.

RVU and productivity pay models

Hospital systems and large groups increasingly pay PMHNPs a base salary plus a productivity component measured in work relative value units. It is a model borrowed from physician compensation, and it rewards the people who understand it and quietly penalises the people who do not.

A wRVU is the "work" component Medicare assigns to each billing code. For the codes a PMHNP bills most, the 2026 values are: 99213 1.30, 99214 1.92, 99215 2.80, the 90833 30-minute psychotherapy add-on 1.71, 90836 2.17, a 90791 diagnostic evaluation 3.84, and 90792 with medical services 4.16.¹⁴ A 30-minute follow-up with medication management and brief therapy, billed as 99214 plus 90833, is 3.63 wRVUs.¹⁴

Your pay under this model is a conversion rate multiplied by your wRVUs, usually above a threshold that the base salary "buys". The conversion rate is the number to negotiate. For psychiatrists, self-reported rates in October 2026 had a median of $60 per wRVU with a middle half of $48.75 to $62.00.¹³ No equivalent published benchmark exists for psychiatric NPs; rates offered to NPs are generally lower than the physician rate in the same organisation, and the offer letter is the only reliable source for yours.

Two calculations to run on any productivity offer.

• Back out the implied rate. If the base is $140,000 and the annual threshold is 3,500 wRVUs, the employer values your work at $40 per wRVU up to the threshold. If the bonus rate above the threshold is lower than that, the model is designed so you earn progressively less for each extra patient.
• Check the threshold against a real day. At 3.63 wRVUs per 30-minute follow-up and 14 completed visits a day, you generate about 51 wRVUs a day, or roughly 11,000 a year on 220 clinic days. A 3,500 threshold would then be trivially met; a 9,000 threshold would be most of your year before a bonus appears. Ask what the median NP in the department actually billed last year.

What productivity models do not count: documentation time, no-shows, care coordination, collateral calls and supervision of other staff. A contract that pays purely on wRVUs with no base, or with a base that is "reconciled" against production at year end, has moved the whole operational risk of the clinic on to you.

How to tell if you are underpaid

"Underpaid" is only meaningful against a benchmark that matches your situation, so pick the right row.^2378911

Beyond the headline number, five signs that are reliable in practice:

1. Your salary has not moved since you were hired and the job postings for your role have. The advertised median for PMHNP roles rose to $166,000 by October 2026; if your organisation is advertising your job at a higher range than you are paid, you are the discount.⁹
2. You are salaried and work a contractor's hours. Medscape's hourly NPs out-earned salaried NPs by about $19,000 in 2024, largely because the hourly model pays for the extra sessions and the salary model absorbs them.⁷ If you routinely chart past the end of a salaried day, convert your real hours to an hourly rate and compare it with the $63.61 median.
3. You are funding a collaborating physician yourself. Up to $30,000 a year off the advertised rate, invisible in every salary table.¹⁶
4. Your productivity threshold was set on physician volumes. If the department's NPs rarely clear the threshold, the "bonus" is a number on a slide.
5. The role carries a differential that was never priced. Inpatient call, weekend coverage, corrections, child and adolescent work and controlled-substance-heavy panels all command more in the open market than a general outpatient role. Majorities of NPs in the 2025 Medscape survey — 53% — said they did not feel fairly compensated; the ones who are right about that are usually in this category.⁷

Negotiation levers that move the number

PMHNPs negotiate from a stronger position than almost any other NP specialty. Nurse practitioner employment is projected to grow 41% between 2025 and 2035, the fastest rate of any occupation, and psychiatry is the specialty with the deepest shortage inside that.¹ The levers below are listed in roughly the order they tend to move, from most to least.

• Base, against the right benchmark. Quote the BLS state median and the advertised PMHNP range for the setting, not a national average. An employer in Washington cannot credibly describe $130,000 as market when the state NP median is $156,100.²
• Pay structure, before the number. If the employer uses wRVUs, negotiate the conversion rate and threshold first; a $5 change in the rate on 9,000 wRVUs is $45,000. If they pay per visit, negotiate a guaranteed base for the first twelve months while the panel fills.
• The collaboration cost. In reduced and restricted states, make the employer contract and pay the collaborating physician. It is the single largest hidden deduction in PMHNP contracts.¹⁶
• Loan repayment. The VA's Education Debt Reduction Program runs to $200,000 over five years for qualifying positions;¹² NHSC sites offer their own. For a PMHNP with six-figure graduate debt, a $125,000 salary with $40,000 a year of tax-free repayment is worth more than $150,000 without it.
• Hours and documentation time. A 36-hour patient-facing week with protected charting time is worth real money against a 40-hour week with charting on top, and it is far easier to secure before you start.
• Sign-on and retention bonuses. Common in hard-to-fill psychiatric roles, but they are one-off payments against a recurring shortfall. A $15,000 sign-on is worth less than a $6,000 base increase over three years, and it usually comes with a clawback.
• Protection against the exit. Non-compete radius and duration, tail coverage on claims-made malpractice, and who owns the panel if you leave. None of these is pay, and all of them determine what your next negotiation looks like.

The weakest lever is tenure. Annual increases in salaried PMHNP roles are typically small, and the experience data above shows the curve flattening early. The clinicians at the top of the distribution got there by moving — settings, structures or states — at the points where the market had moved and their employer had not.

Sources

1. 01
   BLS Occupational Outlook Handbook — Nurse anesthetists, nurse midwives and nurse practitioners (May 2025 wages; 2025–35 projections)www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-
2. 02
   BLS Occupational Employment and Wage Statistics — Nurse practitioners (29-1171), May 2025, national and statewww.bls.gov/oes/current/oes291171.htm
3. 03
   ZipRecruiter — PMHNP salary (September 2026)www.ziprecruiter.com/Salaries/Pmhnp-Salary
4. 04
   ZipRecruiter — Average PMHNP salary by state (2026)www.ziprecruiter.com/Salaries/What-Is-the-Average-Pm
5. 05
   Salary.com — Psychiatric nurse practitioner (NP) salary and hourly rate (1 October 2026)www.salary.com/research/salary/alternate/psychiatric
6. 06
   Payscale — Psychiatric nurse practitioner salary (June 2026)www.payscale.com/research/US/Job=Psychiatric_Nurse_P
7. 07
   Weatherby Healthcare — Nurse practitioner salary report, summarising the Medscape 2025 APRN Compensation Report (November 2025)weatherbyhealthcare.com/blog/nurse-practitioner-sala
8. 08
   Barton Associates — PMHNP salary guide 2026 (citing the AANP 2024 NP Compensation Report and ZipRecruiter 2025 locum and telepsychiatry rates)www.bartonassociates.com/np-psychiatry-salary-guide/
9. 09
   PMHNP Hiring — PMHNP salary guide: advertised pay explorer (data as of 27 October 2026)pmhnphiring.com/salary-guide
10. 10
    PMHNP Hiring — 1099 vs W-2 for PMHNPs: compensation comparison 2026pmhnphiring.com/resources/1099-vs-w2
11. 11
    AMN Healthcare — Locum tenens psychiatric nurse practitioner jobs and pay (March 2026)www.amnhealthcare.com/careers/advanced-practice/appl
12. 12
    USAJOBS — Psychiatric Mental Health Nurse Practitioner, Veterans Health Administration, Phoenix area (September 2026)www.usajobs.gov/job/883679300
13. 13
    SalaryDr — Psychiatry wRVU conversion rates (data as of 20 October 2026)www.salarydr.com/salary-components/wrvu-rates/psychi
14. 14
    FastRVU — Psychiatry RVU guide 2026: wRVU values by CPT code (CMS 2026 data)fastrvu.com/articles/psychiatry-rvu-guide-2026
15. 15
    AANP — State practice environment map (updated May 2026)www.aanp.org/advocacy/state/state-practice-environme
16. 16
    DirectShifts — How to find a collaborating physician as a nurse practitioner (April 2026)www.directshifts.com/clinician-resources/how-to-find