Psychiatrist Compensation 2026: Inpatient, Outpatient, Telehealth, Addiction & Child — National Pay Tables

Psychiatry in 2026 has the most diverse compensation landscape of any specialty. A child psychiatrist on staff at a children's hospital, a telehealth psychiatrist at Talkiatry, and a cash-pay outpatient psychiatrist in a private practice can all earn between $300K and $500K with completely different work patterns and lifestyles.

This guide covers what psychiatrists are actually earning across all major practice types in 2026, including the venture-funded telehealth platforms (Talkiatry, Cerebral, Brightside, Headway) that have reshaped the comp market.

National compensation by setting — 2026

Telehealth platform breakdown

The DTC platforms now employ ~30% of newly graduating psychiatrists. Each has a distinct compensation model:

Talkiatry is the highest-quality W-2 telehealth offer in the market — they take only 4-day work weeks, no weekends, full benefits. The trade-off is lower base than a traditional outpatient role, but the lifestyle gain is significant.

RVU targets (employed psychiatry)

• Outpatient: 4,200–5,200 wRVU target, $48–$62/wRVU bonus rate
• Inpatient: 4,800–5,800 wRVU, $52–$68/wRVU
• Consult-liaison: 4,000–5,000 wRVU, $55–$72/wRVU
• Child / adolescent: 3,800–4,800 wRVU (longer visits), $58–$75/wRVU

Psychiatry RVU targets are lower than internal medicine because visits are longer (45–60 min med management, 90+ min therapy + meds). A typical outpatient psychiatrist sees 16–22 patients/day; achieving 4,800 RVU requires sustained 18+ patients/day at 60% follow-ups + 40% new evals.

Cash-pay private practice math

For psychiatrists running cash-pay practices in metro markets:

• Initial eval: $400–$650 (60–90 min)
• Med management follow-up (15–25 min): $200–$350
• Therapy follow-up (45–55 min): $300–$450

A solo cash-pay psychiatrist seeing 20 patients/day, 4 days/week, 46 weeks/year:

• 3,680 visits × $275 average = $1.012M gross
• Overhead (rent, biller, EHR, malpractice): 22–28% = $245K
• Net 1099: ~$760K

This is the high end. The realistic year-1 cash-pay practice ramps to 50–70% capacity ($350K–$520K net) and stabilizes at full capacity in year 3.

Top-paying states — 2026

• California (Bay Area, LA): Outpatient $385K, cash-pay private practices push to $700K+
• New York (Manhattan): Outpatient $370K, cash-pay potential $800K+
• Massachusetts: Outpatient $355K, child psych $410K
• Connecticut: Inpatient $385K — high demand at Yale-affiliated systems
• New Jersey: $345K outpatient driven by NYC commuter overflow

Psychiatry is one of the few specialties where coastal metros pay more than rural — the cash-pay differential and demand density flip the usual rural-premium pattern.

Locum tenens rates

• Outpatient: $200–$285/hour, $1,700–$2,400/day
• Inpatient: $235–$325/hour, $2,000–$2,800/day
• Child / adolescent: $260–$355/hour
• Addiction medicine (with X-waiver / buprenorphine): $245–$340/hour
• Telehealth locum: $185–$245/hour (lower than in-person)

What we see at Ava Health

Demand for child & adolescent psychiatrists is at the highest level we've ever tracked. Most candidates have 3–5 simultaneous offers. The hardest-to-fill setting in 2026: child inpatient — only 1,500 board-certified child psychiatrists nationally do inpatient work, and the wait lists at children's hospitals are 6+ months.

For candidates considering telehealth: Talkiatry's W-2 4-day model is the strongest combination of comp and lifestyle in our placement data. We've placed 14 psychiatrists into Talkiatry since 2024, all retained at 12 months. The high-1099 Headway model can pay more but the income is variable and depends entirely on patient volume you build yourself.

Related: Telehealth Psychiatry Comp 2026, 1099 vs W-2 Healthcare Offer Math.