Locum Tenens Physician Salary 2026: Rates by Specialty and How Locums Work

Locum tenens — Latin for "to hold the place of" — is the practice of physicians working temporary assignments at hospitals, clinics, and health systems as independent contractors or through staffing agencies. In 2026, approximately 50,000 physicians work locum assignments at some point during the year, and the market has grown steadily as health system staffing flexibility demand has increased. Locum rates have risen 8–15% since 2022 as physician shortages have deepened.

Locum tenens rates by specialty (2026)

Specialty	Typical Rate Range	High-Need/Rural Premium
Emergency Medicine	$220–$310/hr	$310–$400/hr
Anesthesiology	$220–$280/hr	$280–$375/hr
CRNA	$150–$200/hr	$200–$260/hr
Hospitalist (IM/FM)	$110–$150/hr	$150–$220/hr
Psychiatry	$200–$275/hr	$275–$375/hr
Radiology (on-site)	$200–$280/hr	$280–$370/hr
Teleradiology	$80–$130/RVU or $170–$230/hr	Night differential +$25–40
General Surgery	$200–$270/hr	$270–$360/hr
Orthopedic Surgery	$250–$350/hr	$350–$450/hr
Cardiology (Interventional)	$275–$375/hr	$375–$500/hr
Neurology	$175–$250/hr	$250–$325/hr
OB/GYN	$200–$275/hr	$275–$350/hr
Family Medicine / Primary Care	$100–$140/hr	$140–$200/hr
Pediatrics	$110–$150/hr	$150–$200/hr

Rates vary significantly by geography, assignment length, facility type, and urgency. Short-notice "stat" placements (< 2 weeks) command 15–30% premiums. Rural critical access and federal facilities (IHS, VA) typically offer premium rates to attract locum coverage.

What's included in a locum tenens offer

Most locum contracts include some combination of:

• Hourly rate or daily rate — the base compensation, paid on a 1099 basis (you are typically an independent contractor)
• Travel reimbursement — roundtrip airfare or mileage from your home
• Housing stipend — furnished short-term housing or a housing allowance (typically $80–$150/night equivalent value)
• Malpractice insurance — most agencies provide occurrence-based coverage; verify tail coverage for claims-made policies
• Licensing and credentialing support — top agencies will fund and support state license applications and help expedite hospital credentialing

These benefits add $30,000–$80,000+ in annualized value on top of the hourly rate — a significant factor when comparing locum total comp to an employed position's W-2 base.

Locum tenens tax math — the full picture

Locum physicians working as 1099 contractors pay self-employment tax (15.3%) on top of federal and state income taxes. At $300,000 gross 1099 income, estimated total tax burden commonly runs 38–46%. The math:

• Self-employment tax: ~$22,000 (on first ~$160K of net SE income) + 2.9% above that
• Section 199A deduction: may reduce taxable income by up to 20% for qualified business income if eligible (consult a CPA)
• Deductions: malpractice tail, travel to and from assignments, professional dues, CME, licensing fees, home office (if you have one)
• Retirement: Solo 401(k) or SEP-IRA allow higher contribution limits — a major benefit of 1099 status

After-tax comparison example: A hospitalist earning $135/hr for 48 weeks generates ~$259,200 gross. After SE tax + income taxes, net is approximately $155,000–$175,000 — comparable to a $195,000 W-2 employed position after benefits and retirement match are included.

How to evaluate a locum offer — checklist

• Malpractice type: Occurrence vs claims-made? Who pays tail? Tail coverage can cost $20,000–$50,000 out of pocket if you're responsible.
• Credentialing timeline: Is the facility joint-commission accredited? Hospital credentialing can take 60–90 days. Ask if temporary privileges are available to start sooner.
• State licensure: Do you hold a current, active license in the assignment state? Locum agencies can help accelerate but can't create a license from scratch overnight.
• Exclusivity clauses: Some agency contracts restrict you from taking direct placements at the same facility. Negotiate this out where possible.
• Pay period and terms: Net-30 vs biweekly? Float your income requirement accordingly.
• Assignment length and extension options: 13 weeks is standard; 4–8 weeks is available but comes with higher rates. Extensions are common when you perform well.

Major locum tenens agencies (2026)

The locum market is served by a mix of national staffing firms and specialty boutiques. Major players include CompHealth (CHG Healthcare), Staff Care (AMN Healthcare), Weatherby Healthcare, Barton Associates, Jackson + Coker, Global Medical Staffing, and VISTA Staffing Solutions. Boutique firms often offer higher rates for specific specialties or geographies. Negotiating between 2–3 agencies for the same role type is common practice.

What we see at Ava Health

Locum tenens is a significant segment of our physician recruiting pipeline. We see highest demand for locum EM, hospitalist, and psychiatry coverage — these three specialties account for the majority of short-term placement requests from our health system clients. Physicians who already hold multi-state licenses (particularly NLC compact RN + MD dual practitioners, or MDs in multiple compact-adjacent states) command a premium because they eliminate the credentialing lag.

Related: Emergency Medicine Physician Salary, Anesthesiologist Compensation, Hospitalist Contract Guide, PA Compensation 2026.