How Much Do Locum Physicians Make? 2026 Compensation by Specialty
Locum tenens work remains one of the most flexible and lucrative paths in medicine. In 2026, a physician willing to travel and cover open shifts can out-earn many staff colleagues by 20-40%, with the added benefit of control over schedule and assignment selection. But rates vary enormously by specialty — a locum emergency physician can earn $350/hour while a locum family medicine doctor may earn $140/hour.
This guide breaks down 2026 locum tenens compensation by specialty, including typical hourly rates, daily rates, and what to expect in total compensation.
How Locum Physicians Are Paid
Most locum contracts are structured as either hourly or daily rates, with the specific structure determined by specialty and setting:
- Hourly rate: Used for shift-based specialties (ER, hospitalist, anesthesia, urgent care). Typical shifts are 8, 10, or 12 hours.
- Daily rate: Used for clinic-based specialties (primary care, psychiatry, outpatient specialty). A "day" is typically 8-10 clinical hours.
- Call stipends: Additional pay for taking call, typically $100-$500/24-hour call day depending on specialty.
- Expenses covered: Travel, housing, and malpractice insurance are typically paid by the staffing agency or facility — not out of the physician's rate.
2026 Locum Tenens Rates by Specialty
| Specialty | Typical Hourly Rate | Typical Daily Rate | Annual Equivalent (Full-Time) |
|---|---|---|---|
| Emergency Medicine | $275 - $375 | $2,800 - $3,800 | $475,000 - $650,000 |
| Anesthesiology | $240 - $320 | $2,400 - $3,400 | $450,000 - $600,000 |
| CRNA | $200 - $260 | $2,000 - $2,800 | $375,000 - $500,000 |
| Hospitalist / Internal Medicine | $170 - $230 | $1,700 - $2,400 | $320,000 - $440,000 |
| Psychiatry | $200 - $280 | $2,000 - $2,900 | $370,000 - $520,000 |
| Radiology (teleradiology) | $220 - $300 | Not typical | $420,000 - $570,000 |
| OB/GYN | $210 - $290 | $2,100 - $3,000 | $400,000 - $550,000 |
| General Surgery | $230 - $330 | $2,400 - $3,500 | $440,000 - $620,000 |
| Orthopedic Surgery | $280 - $400 | $2,800 - $4,000 | $530,000 - $750,000 |
| Cardiology | $250 - $340 | $2,500 - $3,500 | $470,000 - $640,000 |
| Neurology | $210 - $280 | $2,100 - $2,900 | $400,000 - $520,000 |
| Family Medicine | $130 - $180 | $1,300 - $1,800 | $240,000 - $330,000 |
| Urgent Care | $140 - $200 | $1,400 - $2,000 | $260,000 - $370,000 |
| Pediatrics | $130 - $180 | $1,300 - $1,800 | $240,000 - $330,000 |
| Dermatology | $300 - $450 | $3,000 - $4,500 | $550,000 - $825,000 |
Source: Aggregated 2026 locum market data from Weatherby Healthcare, CompHealth, LocumTenens.com, and Medscape Locum Survey 2025. Annual equivalents assume ~1,900 clinical hours (48 weeks x 40 hours) and do not deduct self-employment tax, health insurance, or retirement contributions.
Why Locum Rates Are Higher Than Staff Rates
Locum rates often appear 20-40% above staff physician hourly equivalents. Several structural factors drive this:
- No benefits loading: Staff physicians cost employers an additional 25-35% on top of base salary in benefits (health insurance, retirement match, malpractice, PTO, CME). Locum rates roll most of this into the hourly rate — but the physician pays their own benefits.
- Coverage premium: Facilities pay locums to fill gaps left by vacancies, parental leave, sabbatical, or sudden departures. Short-notice coverage commands a premium.
- Geographic premium: Rural and underserved facilities pay 15-25% above urban rates to attract coverage, since their staff recruiting challenges are greater.
- Flexibility premium: Locums accept no job security, benefits, or long-term relationships — the higher rate compensates for that risk.
What Reduces Take-Home on Locum Contracts
A $300/hour locum rate doesn't translate directly into staff-equivalent compensation. Key deductions include:
- Self-employment tax: 15.3% on the first $168,600 (2024 cap, rising annually); Medicare portion continues beyond. Most locums are 1099 contractors.
- Health insurance: $12,000-$24,000/year for family coverage purchased on the individual market.
- Retirement contributions (self-funded): SEP-IRA or Solo 401(k) — can contribute up to ~$70,000/year, but it's entirely out of the physician's pocket.
- Unpaid time off: Vacation, sick days, CME, and any gaps between contracts are unpaid.
- Quarterly estimated taxes: Must be paid by the physician directly, with penalties for underpayment.
Specialties With the Highest Locum Demand
While rates matter, demand matters more for sustained locum work. Specialties with consistently high demand in 2026 include:
- Emergency medicine: Highest volume of assignments; rates remain strong in rural and mid-size facilities.
- Hospitalist: Expanding service lines and burnout-driven turnover keep demand high.
- Psychiatry: Severe shortage, especially for child/adolescent and addiction specialists.
- Anesthesia (both MD and CRNA): Operating room coverage is a persistent need.
- OB/GYN: Rural hospital closures have intensified coverage needs in remaining facilities.
How Recruiters Build a Locum Pipeline
For healthcare facilities and staffing agencies, maintaining a deep locum bench requires constant sourcing. Ava Health's database of 850,000+ providers includes licensing information across all 50 states, enabling rapid identification of physicians licensed in hard-to-cover geographies.
Related reading: Locum Tenens Guide 2026, Locum vs. Permanent Positions: Pros and Cons, Emergency Medicine providers.