Locum tenens pay for PAs: A physician assistant's guide to salary and compensation
July 28, 2026
If you are considering working locum tenens as a physician assistant (PA), one of the first questions you likely have is how the pay for temporary roles compares to a permanent position. The short answer is that locum tenens PAs often earn higher hourly rates, but total compensation depends on more than just that hourly rate.
Your specialty, experience, practice setting, location, patient volume, and even whether you are taking call can all influence your bottom line. On top of that, many locum tenens assignments include benefits and expenses, such as travel, housing, licensing, and malpractice coverage—costs that would otherwise come out of your own pocket.
So, how does locum tenens pay work for PAs, and how much do locum tenens physician assistants make?
How much do locum tenens physician assistants make?
Locum tenens physician assistants typically earn between $70 and $135 or more per hour, depending on the assignment. General practice and urgent care roles tend to fall toward the lower end of that range, while surgical specialties and highly specialized inpatient roles often command substantially higher rates.
Hourly pay varies because locum tenens compensation reflects market demand rather than a standardized salary structure. As an example: When a hospital or clinic needs coverage quickly or struggles to recruit permanent clinicians, it often pays a premium to fill the position.
Several broader workforce trends also influence demand for physician assistants. The U.S. Bureau of Labor Statistics projects PA employment to grow much faster than the average occupation over the next decade, while physician shortages are increasing reliance on advanced practice providers across many specialties.
In summary, the hourly rate you receive ultimately depends on several factors, including:
● Your specialty and procedural skills
● The clinical setting
● Geographic location
● Patient volume
● Years of experience
● Overtime, call coverage, and weekend shifts
How does locums pay actually work? Locum PA Jason Raehl explains:
What factors affect locum tenens PA pay?
PA Jason Raehl works a full-time job and enjoys traveling on the side. He appreciates the hourly rate and overtime pay associated with locums assignments:
When you work, you get paid for that work. If you work more than 40 hours, you get paid time and a half for that work.
“So, if you have a lighter week, that’s great, and you have more time to explore and do other things. If you have a heavier week, then you are rewarded for that extra work.”
Here’s what else influences what you earn.
Specialty and skill set
Among all compensation factors, specialty typically has the greatest influence on hourly rates.
PAs who specialize or have advanced procedural skills typically earn higher rates. For instance, a PA with advanced surgical assist experience or dermatology expertise may earn more than a generalist.
Facilities aren't simply paying for credentials. They're paying for clinicians who can step into an established workflow with minimal onboarding and begin caring for patients immediately.
Clinical setting
Where you work matters almost as much as what you practice.
A physician assistant covering an outpatient family medicine clinic generally has different responsibilities—and different compensation—than someone working overnight in an intensive care unit or assisting in a cardiovascular operating room.
Assignments involving patients with acute needs, complex procedural responsibilities, or coverage around the clock generally pay more than outpatient positions with lower patient volumes.
Inpatient versus outpatient, hospital versus clinic, urgent care versus surgical center—each carries different rate norms.
Location and demand
Geography has a significant impact on locum tenens compensation across the board.
Many of the highest-paying assignments are located in places where recruiting permanent providers is an ongoing challenge. Rural communities, critical access hospitals, or federally designated Health Professional Shortage Areas (HPSAs), or states with persistent provider shortages tend to offer higher compensation to attract clinicians willing to travel.
Alaska is frequently cited as an example because of its remote communities and limited provider supply, but many remote regions throughout the lower 48 also offer premium rates. In recent years, several Midwestern states have climbed into the highest-paying markets for locum tenens providers.
Patient volume
Higher-volume settings, such as emergency departments experiencing seasonal surges, urgent care centers, or hospitals managing large inpatient census, often offer higher compensation to source locums quickly.
Some of these assignments may also include productivity incentives or additional compensation tied to overtime.
Experience
Your level of experience influences both the types of assignments available and what facilities are willing to pay.
A physician assistant with several years of independent practice, procedural expertise, or subspecialty experience will typically qualify for a wider range of higher-paying assignments than someone entering practice.
Most healthcare facilities hiring locum tenens providers expect physician assistants to arrive ready to practice with minimal supervision. Because of that, many assignments require at least one or two years of clinical experience and aren’t available to new graduates.
Surgical PA Hugh Degannes encourages newer clinicians to gain experience before pursuing locum tenens positions. "Get some experience under your belt and then maybe do some travel work. I think it'll be worth it."
Overtime and call pay
Many locum tenens assignments include additional compensation for overtime hours (time-and-a-half for 40+ hours), on-call coverage, callback shifts, weekend differentials, or holiday coverage, which can significantly increase total compensation.
Which PA specialties earn the highest locum tenens compensation?
Pay varies widely by PA specialty. Some command higher hourly rates simply because there's more demand than there are providers to meet it. Others pay a premium because they require advanced, hands-on skills that take years to develop.
Actual compensation depends on the employer, location, schedule, and specific assignment requirements—but here are some of the specialties currently seeing the strongest demand for locum PAs:
Cardiology and cardiovascular surgery
Cardiovascular physician assistants continue to be among the highest-paid locum tenens providers due to two long-term trends: an aging population with a growing burden of cardiovascular disease and persistent shortages of cardiologists and cardiothoracic surgeons.
Because these positions require specialized procedural knowledge, facilities often offer premium hourly rates to secure experienced clinicians.
Critical care
Intensive Care Units (ICUs) require experienced clinicians who can manage medically complex patients, respond quickly to changing conditions, and collaborate with multidisciplinary teams around the clock. Recruiting permanent critical care providers has become difficult in rural hospitals and facilities experiencing high burnout rates.
As a result, hospitals frequently rely on locum tenens coverage to maintain staffing levels without compromising patient care.
Dermatology
Higher compensation is standard for assignments in surgical dermatology, cosmetic services, and fast-paced outpatient environments compared to routine clinical care. Since dermatology offices often have long waiting lists, hiring temporary help is a useful way to keep seeing patients while searching for permanent staff or covering for a doctor on leave.
Emergency medicine and urgent care
The 24/7 nature of emergency departments creates a reliable and constant demand for locum providers. Because the job involves shift work, nights, weekends, and unpredictable patient surges, it usually comes with very competitive hourly pay.
At the same time, urgent care centers have multiplied as patients choose them over emergency rooms for non-life-threatening care. However, their extended evening and weekend hours create a persistent staffing challenge. While hourly rates are generally lower in some surgical specialties, opportunities are plentiful, and assignments are often available nationwide.
General surgery
Healthcare facilities routinely utilize seasoned locums PAs to handle first assisting in the operating room, inpatient rounds, postoperative management, and the discharge process. The aging workforce and increased surgeon retirements have created a highly competitive market for more experienced surgical physician assistants.
Oncology
Medical oncology continues to see strong demand for physician assistants as advances in cancer treatment help patients live longer. That success has also increased the need for ongoing follow-up care, symptom monitoring, and survivorship services.
How does locum tenens PA pay compare with permanent employment?
Comparing locum and permanent pay requires looking beyond hourly rates versus annual salaries. Permanent physician assistant positions include a predictable base salary, stability, and benefits, while locums positions provide higher hourly rates with variable income and benefits that depend on your agency.
Your locums earnings depend primarily on how many assignments you choose to work throughout the year.
Compensation comparison
Here's how the two compensation models generally compare. Neither model is inherently better. Some physician assistants prefer the predictability of a salaried position, while others prioritize the flexibility and earning potential that locum tenens can provide.
Benefits comparison
Permanent employers generally include health insurance, retirement plans, paid time off, and continuing education as part of a traditional employment package.
Locum tenens physician assistants working through CompHealth also receive a comprehensive benefits package. Eligible clinicians receive health insurance from day one along with dental and vision coverage, a 401(k) with employer match, and optional benefits such as pet insurance and additional voluntary coverage. Those benefits are provided separately from the hourly compensation associated with an assignment.
Terry Rand, a cardiovascular/cardiothoracic surgery PA, explains why she's grateful CompHealth employs PAs as W-2s instead of 1099 contractors.
Non-cash compensation: What the agency covers
When comparing total compensation, it's also worth accounting for expenses that many locum tenens agencies handle on your behalf.
Depending on the assignment, agencies may coordinate and pay for:
State licensing
Credentialing
Travel
Housing
Medical malpractice insurance
These represent significant non-cash compensation that should be factored into total compensation comparisons.
For locums assignments further from home, CompHealth takes care of comfortable housing for you. PA Jason Raehl explains:
How does locum tenens work for physician assistants?
What locum tenens means for PAs
Locum tenens allows physician assistants to work temporary clinical assignments instead of holding a single permanent position. Assignments can last anywhere from a few days to several months, depending on the facility's staffing needs. Some PAs take occasional assignments between permanent jobs, while others build full-time careers working as locum tenens year-round.
Why PAs work locum tenens
Some want to accelerate student loan repayment by taking higher-paying assignments. Some want to serve communities with limited access to healthcare while broadening their clinical experience. Others enjoy having greater control over their schedules, exploring different practice settings, or gaining experience in a new specialty.
“One of the great things about being a locum—especially a locum tenens PA —is you can go into a new setting and learn new things and different ways of doing things,” says Jason. “I was exposed to different types of surgery that I hadn’t done before, which was a great opportunity.”
Cara Bosco, who completed medical work as a PA in Tanzania, adds:
I feel like my medical toolbox is growing with each assignment.
How PAs find locum tenens assignments
Most physician assistants find assignments through staffing agencies like CompHealth. A recruiter helps match clinicians with available opportunities, coordinates interviews, and assists throughout the credentialing and onboarding process.
How PAs are paid
Once you are working an assignment, you are generally paid as a W-2 employee through the agency. For instance, with CompHealth, hours are submitted through a dedicated portal, MyCompHealth, and compensation is paid via weekly direct deposit. If you'd like a deeper explanation of W-2 versus independent contractor arrangements, see Part 2 of our physician assistant locum tenens guide.
Should more PAs try locum tenens? PA Jason Raehl thinks so—here's why.
Additional financial considerations for locum tenens PAs
Taxes
Most physician assistants working locum tenens through CompHealth are employed as W-2 employees rather than independent contractors. Taxes are withheld through payroll, which simplifies filing compared with managing quarterly estimated tax payments as a 1099 contractor.
Multi-state licensing
Working across multiple states can expand the number of assignments available to you, although it may also require obtaining additional licenses. Fortunately, agencies typically manage much of the licensing and credentialing process, thereby reducing the administrative burden. As the PA Licensure Compact continues to expand, qualifying physician assistants may also find it easier to practice across participating states.
Student loan considerations
Certain assignments may provide access to loan repayment or forgiveness opportunities for physician assistants carrying student loan debt. Some rural hospitals, federally designated HPSAs, and underserved communities participate in state or federal loan repayment programs. It's worth discussing available opportunities with your recruiter if loan repayment is one of your career goals.
FAQs
How much do locum tenens physician assistants make per hour?
In 2026, most locum tenens physician assistants earn between $70 and $135 per hour, depending on specialty, location, experience, and assignment details.
Do locum tenens PAs make more than permanent PAs?
Although locum tenens assignments often pay more per hour than permanent positions, total earnings depend on how many assignments you work. Permanent roles typically offer a fixed salary and a more predictable schedule.
Which PA specialty earns the highest locum tenens pay?
Procedure-heavy fields like cardiovascular surgery and critical care command top hourly rates, though final pay varies by employer and location.
Does location affect locum tenens PA salary?
Yes. Facilities in rural communities, critical access hospitals, and provider shortage areas frequently offer higher compensation to attract clinicians.
Are travel and housing included in locum tenens PA assignments?
Many assignments include travel coordination, furnished housing, transportation, and medical malpractice coverage through the staffing agency. Coverage varies depending on the assignment.
Can new graduate PAs work locum tenens assignments?
Some can, but most locum tenens positions require at least one or two years of clinical experience, as facilities generally look for clinicians who can begin practicing with minimal orientation.
Is locum tenens a good option for PAs seeking higher earnings?
For many PAs, yes—locum tenens can mean higher hourly rates than permanent positions, especially in high-demand specialties and underserved areas. But the posted rate is only part of the story. Your actual take-home
depends on benefits, travel and housing support, licensing assistance, malpractice coverage, overtime opportunities, and how many assignments you choose to work.
That's what makes locum tenens appealing to PAs who want more control over their earning potential: the pay structure rewards flexibility and volume, not just tenure. Still, compensation is only one piece of a bigger decision. If you're weighing whether locum tenens fits your long-term career goals, it's worth considering the lifestyle trade-offs and the scheduling flexibility, too.
Continue reading for the full picture on pay, lifestyle, and more →
Have more questions about PA locum tenens pay? Give us a call at 800.453.3030.