What to Pay a Psychiatric Nurse Practitioner
Budgeting for a psychiatric nurse practitioner starts with a data problem: the Bureau of Labor Statistics has no psychiatric-NP occupation — it pools every nurse-practitioner specialty into one series — and the only PMHNP-specific national figure comes from a paywalled association survey.
The two honest numbers are an all-NP median of $132,300 (BLS OEWS May 2025) and a PMHNP survey median of $140,000 total income (AANP, 2023 income).
This guide gives both with their limits, the setting and state rules that move the budget, and the pay structures that fit the federal rules.
At a glance
national median, May 2025 · proxy series — all NP specialties pooled
All NPs (SOC 29-1171)
$132,300
median total income, 2023 income · n = 394, paywalled
PMHNP-certified (AANP survey)
$140,000
25th–75th percentile, May 2025 · employees only
Middle half, all NPs
$117,990–$156,700
Start with what each number is.
BLS OEWS May 2025, SOC 29-1171 (nurse practitioners) is a payroll count of employees — 323,040 of them — but it pools every NP specialty: family, acute care, psychiatric.
Its national median is $132,300, the middle half runs $117,990 to $156,700 (25th to 75th percentile), and the top decile earns from $174,420.
AANP's 2024 NP Compensation Report is the one named, PMHNP-specific source: for NPs certified in the psychiatry/mental health population, median total income was $140,000 (n = 394; mean $146,302) and median base salary $135,000 (n = 329).
Those are 2023 incomes reported by full-time (35+ hours a week) survey respondents — a self-selected sample in the hundreds, and the report is paywalled — never a population estimate like the BLS series.
AANP defines total income as annual income from the main work site including bonuses and incentive payments.
Use the BLS series as profession-wide context, the AANP figures as the closest psychiatric read, and never blend them: different instruments, different years.
Plan on no state number, either — AANP's report has no state-by-specialty table and BLS does not split PMHNPs out, so any "PMHNP salary in [state]" figure you find has no source behind it.
Our PMHNP career guide covers the same data from the job seeker's side.
Setting moves the proxy number.
In May 2025, all-NP medians ran $129,190 in offices of physicians (148,600 employed), $131,100 in offices of mental health practitioners (3,370), $142,100 in outpatient mental health and substance abuse centers (6,300), $136,690 in hospitals (79,530) and $148,850 in psychiatric and substance abuse hospitals (2,900).
Residential facilities read higher still ($166,670), but that cell counts only 1,560 workers, so treat it as a range, not an anchor.
The pattern is also occupation-specific: never assume "hospitals pay more" transfers from another role.
And these are employee wages only — OEWS excludes the self-employed and practice owners, which matters when you benchmark against a market where many PMHNPs contract.
What you pay for beyond the base is the practice-authority structure you hire into.
AANP's state map (updated May 2026) — an advocacy classification, not law — counts 28 full-practice jurisdictions (27 states plus DC), 12 reduced and 11 restricted, but full practice is not independence on day one everywhere: per AANP's November 2025 snapshot, eleven full-practice states carry transition-to-practice requirements (Nevada's applies only to Schedule II prescribing).
Outside the full-practice list, several states have hours-or-years routes out of some or all of the physician agreement, and what each unlocks differs: Illinois (4,000 clinical hours plus 250 CE hours), Kentucky (4 years, separately for nonscheduled legend drugs and for controlled substances), California (3 full-time-equivalent years or 4,600 hours, to a setting-limited certificate), Oklahoma (6,240 hours, to independent prescribing, effective November 1, 2025), among others — though Schedule II or setting limits usually remain.
A new graduate in a transition state cannot anchor a fully independent caseload yet, so budget the collaboration structure alongside the salary.
And in five states — Alabama, Georgia, Missouri, Oklahoma and Texas — an NP cannot prescribe Schedule II stimulants in ordinary outpatient practice at all, so an ADHD-heavy medication-management role needs the physician relationship priced in from the start.
Full, reduced and restricted practice maps each state's rule.
Some cost lines are yours by choice.
Among NPs working under a practice agreement in full-practice states, the most common reason given was that the employer requires it — 74.4% in transition-to-practice states and 80.3% elsewhere (Slade et al.
2025, reported in AANP's snapshot).
If you require the agreement, you carry the physician side of it; our guide to who signs collaborative practice agreements and what they cost covers the mechanics.
Fixed costs are small but real: DEA registration runs $888 per three-year cycle and is required for each principal place of business where controlled substances are dispensed (21 CFR 1301.12(a), 1301.13(e)), and ANCC's PMHNP-BC renews on a five-year cycle requiring 75 CE contact hours, 25 of them in pharmacology — budget both if you cover them as benefits.
For how the role compares with the physician hire, see PMHNP vs psychiatrist.
This page is career and hiring information, not legal or clinical advice, and it is not for someone seeking treatment — confirm scope-of-practice and controlled-substance rules with your state board of nursing, and consult an employment attorney on pay classification.
Ways to structure the pay
Salary
Best for: a full-time prescriber carrying a defined caseload, where you need predictable cost
A fixed weekly amount that does not shrink when visits cancel, paid in full for any week the PMHNP works.
The federal exempt-salary floor is $684 a week ($35,568 a year), the level DOL restored in May 2026.
For a PMHNP, plan around it: the medical exception to the salary test is written for "physicians and other practitioners licensed and practicing in the field of medical science and healing" and names physicians, podiatrists, dentists and optometrists (29 CFR 541.304), while the rules expressly exclude nurses from that exception (29 CFR 541.600(e)).
No DOL ruling we could locate places nurse practitioners on either side of that line — so budget as if the salary test applies.
Trade-off: You carry the cost of slow ramp-ups and no-shows, and the incentive to fill the schedule is weaker.
When to use: The default for employed W-2 roles, and the simplest way to keep the overtime exemption available.
Docking a salaried exempt PMHNP's pay because visits no-showed is a deduction for "time when work is not available", which the salary-basis rule does not allow (29 CFR 541.602(a)(2)).
Salary plus productivity incentive
Best for: practices that want visit volume rewarded without giving up the exemption
A guaranteed weekly salary at or above the $684 floor, plus a set amount for each visit above a threshold — federal rules allow extra compensation on top of a salary guarantee (29 CFR 541.604(a)).
If the base is computed hourly or per shift instead, the guaranteed amount must bear a reasonable relationship to the PMHNP's usual earnings at that rate (29 CFR 541.604(b)); DOL cites 1.5-to-1 or less as reasonable and has called 1.8-to-1 impermissible (FLSA2018-25).
Trade-off: You have to set the threshold yourself — no sourced national productivity norm exists for psychiatric visits.
When to use: The common hybrid for group practices and hospital outpatient programs.
Set the target from your own schedule and templates.
No named survey with a sample size and year establishes a standard psychiatric visit count; vendor "productivity standards" figures have no source behind them.
Hourly or per-visit W-2 pay
Best for: part-time or overflow roles where you accept non-exempt treatment
The PMHNP is paid only for hours worked or visits held.
With no weekly guarantee, budget for the overtime exemption not to be available: for therapists and social workers the rule says so outright, and in January 2026 DOL told an LCSW that a switch to hourly pay "would likely no longer meet the compensation criteria … even if your duties remain the same" (Opinion Letter FLSA2026-1).
That means minimum wage for all hours worked — including documentation time — plus overtime past 40 in a workweek.
Trade-off: Lower fixed cost, but every worked minute is compensable and you must track hours.
When to use: Only with non-exempt treatment: time tracking and overtime.
A flat per-visit rate for recurring visits is closer to what the fee-basis rule says is NOT a fee (29 CFR 541.605) — a "fee" is for a unique job, not "a series of jobs repeated an indefinite number of times".
Do not assume per-visit pay qualifies as fee basis; no DOL ruling addresses per-session behavioral-health pay.
wRVU-based pay
Best for: health-system prescriber roles where production is measured in work RVUs
Pay is a dollar amount per work RVU credited.
CMS's 2026 work RVUs for the codes a PMHNP lives in: 3.84 for a 90791 psychiatric diagnostic evaluation, 3.78 for a 90837 sixty-minute psychotherapy visit, 1.92 for a 99214 medication-management E/M visit, 1.71 for a 90833 psychotherapy add-on, 0.67 for a 90853 group visit.
Note the shape: medication management credits fewer units per encounter than a therapy hour, which is why psychiatric productivity plans usually blend E/M and add-on codes.
The dollar-per-wRVU rate is your contract term — CMS's conversion factor is a Medicare payment input, not a salary.
Trade-off: No citable national $/wRVU benchmark for psychiatry exists in public — MGMA's specialty figures are paywalled — so the rate is negotiated blind.
When to use: Mostly where a health-system compensation committee already runs wRVU plans for its physicians.
RVUs measure work, not pay.
A pure wRVU plan with no weekly guarantee raises the same overtime question as per-visit pay; pair it with a salary guarantee if you claim the exemption (29 CFR 541.604).
Independent contractor (1099) fee split
Best for: rarely — a PMHNP who genuinely runs their own practice inside yours
The clinician is paid a share of collections and controls how the work is done.
Classification turns on DOL's economic-reality factors and the IRS common-law test — under DOL's Fact Sheet #13, whether the worker "is licensed by State/local government" has no bearing and "the time or mode of pay does not control"; under the IRS, a contract label "is not sufficient".
Trade-off: No payroll taxes or benefits, but misclassification means back taxes and wage claims — and you control far less of the work.
When to use: Only for clinicians independently established in the market; get counsel's read first in ABC-test states.
California shows the trap: its professional-services carve-out to the ABC test (Lab.
Code §2783) names physicians, dentists, podiatrists, psychologists and veterinarians — not nurse practitioners — so a PMHNP contracting with your practice is judged under the ABC test, whose "outside the usual course of the hiring entity's business" prong a psychiatric practice cannot satisfy.
The federal relief provision is also lost if you have treated any substantially similar worker as an employee after 1977 (IRS Pub.
15-A) — mixed W-2/1099 benches are the exposure.
The Psychiatric Nurse Practitioner Hiring Market Right Now
The psychiatric nurse practitioner openings you are competing with, from the 455 active listings on BehavioralHires as of October 29, 2026.
Employers with the most openings
Where the openings are
Pay employers post
- Median $197,500 a year; the middle half of posted pay runs $197,500 to $224,500 (119 listings that state a salary; 61 of them from LifeStance Health)
- 27% of psychiatric nurse practitioner listings state any pay at all, so posting a range helps yours stand out.
Benefits and work arrangement
- 39% remote or telehealth and 29% hybrid; the rest are on-site
- 401k Matchnamed in 74%
- Health Insurancenamed in 58%
- Dental & Visionnamed in 55%
- Malpractice Insurance Coverednamed in 43%
- PTO / Paid Time Offnamed in 36%
Source: active psychiatric nurse practitioner listings on BehavioralHires, updated daily. Pay figures use only listings that state pay (midpoint of each posted range). Benefits count listings that name the benefit; a listing that doesn’t mention one may still offer it.
See the listings →Questions employers ask
What is the average salary for a psychiatric nurse practitioner?
There is no BLS psychiatric-NP series.
The closest named PMHNP figure is AANP's 2024 NP Compensation Report: median total income of $140,000 for psychiatry/mental-health-certified NPs (2023 income, full-time respondents, n = 394, paywalled survey), with median base salary of $135,000 (n = 329).
BLS OEWS May 2025 puts the all-NP median (SOC 29-1171, every specialty pooled) at $132,300.
A "$145,000 median" circulates on staffing sites but appears nowhere in the AANP tables — the AANP number is $140,000.
Do I have to pay a PMHNP a salary of $684 a week to keep the overtime exemption available?
Budget as if yes.
The FLSA exception that skips the salary test is written for "physicians and other practitioners licensed and practicing in the field of medical science and healing" and names physicians, podiatrists, dentists and optometrists (29 CFR 541.304), and the rules expressly exclude nurses from that exception (29 CFR 541.600(e)) — but no DOL ruling we could locate says where nurse practitioners fall.
Paying at least $684 a week ($35,568 a year, the level DOL restored in May 2026) on a salary basis keeps the exemption available regardless of how that question is resolved.
Can I pay a PMHNP per visit, or hire one as a 1099 contractor?
Per-visit W-2 pay is the risky one: a flat rate for recurring visits resembles what the fee-basis rule says is not a fee, so the clinician is likely non-exempt — minimum wage for all hours including documentation, plus overtime past 40.
For 1099, neither the license nor per-visit pay decides anything: classification turns on control and economic reality under DOL's and the IRS's tests.
In California the ABC test's professional carve-out does not name nurse practitioners, and the federal relief provision is lost if your practice has W-2 clinicians in substantially similar roles.
Is there a PMHNP salary figure for my state?
No citable one.
AANP's compensation report has state tables for all NPs but no state-by-specialty table, and BLS does not split PMHNPs out of SOC 29-1171.
BLS does publish all-NP medians for every state, and they are useful context — but they are all-NP figures, not PMHNP rates.
Benchmark from the all-NP state figure plus your own offer data, and treat any "PMHNP salary in [state]" number as unsourced.
More hiring resources
Ready to post your PMHNP opening?
State the pay model and the practice-authority structure in the posting, so candidates know exactly what they are walking into.