How does locum tenens pay and salary work for physicians?
May 27, 2026
The concept of locum tenens—or temporary healthcare assignments—has been around since 1979, when CompHealth introduced the industry to send physicians to rural and underserved areas.
Though 27% have worked locum tenens at some point in their careers, and 67% of healthcare providers report being familiar with locums, many still have questions about how these assignments work.
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Regardless of the reason for working locum tenens—whether it’s to control your own schedule, find work between full-time jobs, or navigate personal life transitions—providers all want to know about one thing:
The money.
What is locum tenens, and why do physicians choose it?
Learn more about locum tenens, why healthcare facilities use them, and why providers work locums:
What is the average locum tenens physician pay rate by specialty?
Locum tenens providers usually earn a higher hourly rate than physicians who work full time (though rates vary).
What I really like about CompHealth and locum tenens is that I’m getting a comparable salary to what I would make working elsewhere
Here are wage ranges of a doctor working locum tenens for several specialties, according to 2026 Locumstory data:
Anesthesiology jobs: $300 – $425/hour
Emergency medicine jobs: $250 – $300/hour
Family medicine jobs: $120 – $135/hour
General surgery jobs: $150 – $200/hour
Hospitalist jobs: $170 – $190/hour
Obstetrics and gynecology jobs: $150 – $200/hour
See pay for more specialties: Locum tenens pay trends (Locumstory)
What factors affect average wage for locum doctors?
Several variables affect locum tenens pay, including:
Location and facility type
Facilities in rural areas generally pay locum tenens physicians more than urban facilities because it is more difficult to attract candidates to these areas.
Specialty demand
Physicians who work in neurosurgery, vascular surgery, cardiology, anesthesiology, and emergency medicine can often expect to earn higher salaries. However, there is an ongoing need for general surgeons, internal medicine physicians, and psychiatrists.
Shifts needed
If you are on call or working weekends or holidays, you may earn a higher hourly rate as a locum tenens provider. The length of your assignment—some last only a weekend while others extend for weeks or months—also affects pay.
Patient load and skill set
You will often receive more in compensation if your position requires specialized skills or has a higher patient census.
Where do locum tenens physicians earn more money?
Some states offer higher locum tenens pay for physicians. Here are the top 10 states with the highest average locum tenens salary, according to 2026 data from Locumstory:
Arkansas
Ohio
West Virginia and Missouri
Delaware
New Hampshire
South Dakota
Mississippi
Tennessee
Indiana
Rhode Island
Regardless of the state, most locum tenens providers earn a higher hourly wage than they did at their permanent position and can continue to pay off student loans and other expenses.
Dr. Wendy Ballenger, an internal medicine physician and pediatrician, notes that taking temporary positions—and eliminating other expenses, like housing—gives you more income to pay off debts.
“Many of us, when we graduate from residency, are in hundreds of thousands of dollars of debt," says internal medicine physician Dr. Wendy Ballenger. "Paying your loans each month can be more than a house payment."
Locum tenens helps because it takes your house payment away and allows you to work with your tax advisors. You can make enough money to pay for those loans.
Why should you work with a locum tenens agency?
When you work with a locum tenens agency, your recruiter negotiates your assignment with the facility so you don’t have to. They ensure you earn a competitive wage but also communicate the shifts you prefer, call or holiday work, and other factors that affect your position. Your recruiter can help you get other benefits that save you money, including per diem payments, shift premiums, and mileage reimbursement.
A locum tenens recruiter also gets to know you and your preferences and looks for positions that fit your salary and location requirements.
I love CompHealth. They’ve been with me throughout my 16-year career.
“Whenever I’m at a transition point, I call Trudy and ask, ‘What have you got for me?’” Dr. Davis says. “It’s been a wonderful experience working with CompHealth. When doctors tell me they’re thinking about doing locums, I say, ‘Go with CompHealth. They treat you so well, and everything is all in line.’”
Find the ideal locum tenens agency partner: How do top locums agencies compare?
What does the locum tenens agency pay for?
Once you book an assignment, the agency pays your hourly rate. Most locum tenens agencies also cover:
Licensing, credentialing, and privileging
Larger locum tenens companies often have in-house teams to help you gather and maintain the necessary paperwork for temporary assignments. Established agencies should have relationships with boards and facilities nationwide and know how to move through the licensing, credentialing, and privileging processes as quickly and efficiently as possible. Thanks to the recent efforts by the Interstate Medical Licensure Compact Commission, it’s now faster to get a license in more than 43 states across the country.
Medical malpractice coverage
While you’re on assignment, you’re covered by the agency’s malpractice policy. However, the specific type of malpractice coverage may differ by locum tenens agency. CompHealth provides claims-made malpractice, which includes tail coverage for life.
Travel and housing
The locum tenens agency will book flights and rental cars for you and take care of housing (generally a hotel near the facility for short-term assignments and an apartment or Airbnb for longer assignments).
I plan on working locum tenens for another 10 years. We have some debts we want to pay off in the next three years, and after that, the idea is just to work two weeks on, two weeks off—enough to pay off the mortgage and put some money away.
"I don't plan to return to a permanent job like I had the rest of my career. As long as locums works, I'll keep doing that."
What does the locum tenens agency not pay for?
Because locum tenens physicians are independent contractors, they are not employed by the locum tenens agency. This means they must pay:
Taxes
The locum tenens agency does not take state, federal, Medicare, and Social Security taxes from provider paychecks, so physicians are responsible for making estimated tax payments. A locum tenens physician must also pay income taxes in each state they are in. However, a state tax credit for the nonresident state tax liability can reduce the home state tax (state of residence generally taxes all income) and should fully or partially eliminate any double-state taxation.
Curious how taxes work for locums? A beginner's guide to locum tenens taxes
Medical insurance and benefits
Physicians must pay for their own benefits, including health and life insurance or retirement plans. Some providers already have benefits through their permanent position. Full-time locum tenens typically buy health insurance through a health exchange or use a spouse’s plan.
However, locum tenens providers, as independent contractors, can often claim more work-related expenses than the typical employee, including travel, meals, housing, work tools and supplies, and continuing education.
Discover your options: Finding health insurance as a locum physician
Dr. Paymon Kayhani shares how locum tenens is a great way to not only earn extra income, but it can also help to significantly reduce your tax burden.
When and how are locum tenens paid?
The locum tenens agency, not the facility where a provider is working, pays the locum tenens provider. The time frame and process vary by agency. For example, CompHealth providers enter their time through the MyCompHealth mobile app or online portal—where you manage the details of your current and future assignments—and are paid weekly via direct deposit.
How do healthcare staffing agencies make money?
Hospitals and other healthcare facilities contact locum tenens agencies when they need help finding temporary coverage. Locums agencies then turn to their network of healthcare professionals to find the right match between the provider and the facility.
The locum tenens agency pays the provider for working the assignment. Facilities pay the agency to find a provider to fill the position and take care of things like licensing, credentialing, privileging, housing, and travel arrangements.
Locum tenens is a great way for physicians to earn a competitive wage while also enjoying more flexibility and independence in their careers.
Common FAQs about locums pay
What is locum tenens pay, and how does it work?
Locum tenens pay is typically hourly or daily compensation for temporary physician assignments rather than a fixed annual salary. Providers are usually paid through a staffing agency, which contracts with healthcare facilities. Pay rates vary based on specialty, location, and demand, and assignments can range from a few days to several months.
Do locum tenens physicians get paid hourly or per assignment?
Most locum tenens physicians are paid hourly, though some assignments offer daily or shift-based rates. Hourly pay is the most common structure because it accounts for actual time worked, including overtime, call coverage, and extended shifts.
How much do locum tenens physicians make?
Locum tenens pay varies widely by specialty and location, but physicians often earn higher hourly rates than permanent roles. High-demand specialties like anesthesiology, radiology, and emergency medicine typically command the highest rates. Total earnings depend on how often you work and the types of assignments you accept.
Is locum tenens pay higher than a full-time physician salary?
Locum tenens hourly rates are often higher than equivalent salaried positions. However, total annual income depends on how many assignments you take. While locum providers may earn more per hour, they typically don’t receive traditional benefits like employer-sponsored health insurance or retirement plans.
What factors affect locum tenens pay rates?
Several factors influence locum tenens pay, including:
Medical specialty and subspecialty
Geographic location (rural vs. urban)
Assignment length and urgency
Shift type (weekends, call, holidays)
Provider experience and skill set
Higher demand and less desirable locations often result in higher pay rates
Do locum tenens jobs include travel and housing?
Yes, most locum tenens assignments include travel and housing arranged and paid for by the staffing agency. This typically covers airfare, rental cars, housing, and sometimes per diem stipends for meals and incidental expenses.
Are locum tenens physicians paid as independent contractors?
In most cases, locum tenens physicians are classified as independent contractors and receive a 1099 tax form. This means taxes are not withheld from paychecks, and providers are responsible for managing their own tax payments and deductions.
Do locum tenens physicians have to pay taxes in multiple states?
Yes, locum tenens providers may need to file taxes in each state where they work. Tax requirements vary by state, so many physicians work with a tax professional to ensure compliance and maximize deductions.
What expenses can locum tenens physicians deduct?
Common tax-deductible expenses may include:
Licensing and credentialing fees
Continuing medical education (CME)
Travel not reimbursed by the agency
Home office or business expenses
Because tax situations vary, it’s best to consult a qualified tax advisor.
Do locum tenens jobs include benefits like health insurance?
Locum tenens positions typically do not include traditional employee benefits such as health insurance or retirement plans. However, agencies often provide malpractice insurance and may offer access to optional benefits or resources.
Is malpractice insurance included in locum tenens assignments?
Yes, most locum tenens agencies provide malpractice insurance coverage for the duration of each assignment. This usually includes tail coverage, protecting providers even after the assignment ends.
Can you negotiate locum tenens pay rates?
Yes, locum tenens pay rates are often negotiable. Factors like experience, availability, specialty demand, and assignment urgency can influence negotiations. Working with a recruiter can help you understand market rates and secure competitive compensation.
How often do locum tenens physicians get paid?
Payment schedules vary by agency, but most locum tenens physicians are paid weekly or biweekly. Providers typically submit timesheets to confirm hours worked before payment is processed.
Can locum tenens physicians earn a full-time income?
Yes, many physicians work locum tenens full time and earn a comparable—or higher—income than permanent roles. Income depends on how frequently you take assignments and your specialty.
Is locum tenens worth it financially?
For many physicians, locum tenens is financially advantageous due to higher hourly rates, paid travel, and flexibility. However, providers must account for taxes, benefits, and gaps between assignments when evaluating overall income.
Interested in locum tenens opportunities in your specialty? View current locum tenens openings or give us a call at 800.453.3030.