Healthcare Recruiting
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
| Setting | Median (W-2) | 25th | 75th |
|---|---|---|---|
| Outpatient (employed) | $310,000 | $268,000 | $365,000 |
| Inpatient / consult-liaison | $345,000 | $295,000 | $405,000 |
| Telehealth (DTC platforms) | $295,000 | $245,000 | $355,000 |
| Addiction medicine | $375,000 | $315,000 | $445,000 |
| Child & adolescent psychiatry | $355,000 | $305,000 | $420,000 |
| Forensic psychiatry | $385,000 | $325,000 | $475,000 |
| VA / academic psychiatry | $265,000 | $235,000 | $305,000 |
Telehealth platform breakdown
The DTC platforms now employ ~30% of newly graduating psychiatrists. Each has a distinct compensation model:
| Platform | Structure | Typical earnings |
|---|---|---|
| Talkiatry | W-2, 4-day work week, no nights/weekends | $295K-$345K |
| Headway | 1099, % of session fee | $215K-$385K (variable) |
| Brightside | 1099, async + sync | $185K-$295K (PT-to-FT) |
| Done / Cerebral | W-2 or 1099, ADHD/depression focus | $245K-$315K |
| Hims/Hers (mental health) | 1099, async script-write | $175K-$275K (high volume) |
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.
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