The physician assistant's locum tenens guide: Pay, flexibility, and benefits explained
May 5, 2026
This is part two in a five-part series on everything physician assistants need to know about working locum tenens. If you missed part one, you can read it here: What is locums and how do I get started?
If you’re seriously weighing locum tenens, you’re probably asking a simple question: Is it actually worth it?
For many physician assistants, the answer is yes—but not because locums is perfect. It’s because the tradeoffs can work strongly in your favor when you want better control over your time, stronger earning potential, more variety, or relief from the pressures that come with a traditional permanent role.
How locum tenens pay works for PAs
One of the biggest reasons PAs explore locums is compensation. Locum tenens physician assistant jobs are typically paid hourly, which can feel very different from salaried permanent work. That matters because your time is more visible.
Instead of being salaried, if you work a 16-hour day, you're getting compensated fairly for all 16 hours
For physician assistants working longer shifts or heavier weeks, that difference can feel even more concrete. "If you work more than 40 hours, then you get paid time and a half for that work," shares Jason Raehl, PA in orthopedic surgery.
That kind of pay structure can be especially appealing to PAs who are used to going above and beyond in salaried jobs without seeing a meaningful difference in compensation.
Looking at the full compensation picture
For many PAs, locums pay isn’t just about the hourly rate. It’s about the overall compensation picture.
That includes:
How many hours are guaranteed
Whether overtime is possible
Whether call is involved
Whether travel time affects your schedule
What expenses are covered
Whether benefits are included
How much unpaid time do you plan to take between assignments
A high hourly rate can look less impressive if the schedule is inconsistent or if you’re responsible for major out-of-pocket costs. On the other hand, a rate that looks average at first can become much more attractive when housing, travel, licensing support, malpractice coverage, and benefits are built in.
W-2 vs. 1099: Why it matters for PAs
One of the biggest questions PAs have about locums is whether they’ll be treated as W-2 employees or independent contractors.
Some locums clinicians work as independent contractors, which means handling their own tax planning and often sourcing their own benefits. But CompHealth’s current PA model is W-2 employment, which alters the experience in meaningful ways.
That structure was a deciding factor for cardiovascular/cardiothoracic surgery physician assistant Terry Rand.
With CompHealth, I work as a W-2 employee. Somebody else takes care of my withholding and taxes, and the amount of stress that takes off of me.
For PAs who don’t want extra tax complexity on top of clinical work and travel logistics, that matters.
What about benefits?
Many people assume that working as a locum means giving up benefits. That can be true in some situations, but not all locums roles work that way.
CompHealth offers a range of benefits for eligible physician assistants that begin on day 30 of an assignment, including:
Medical, dental, and vision coverage
Life and disability insurance
Employee assistance program
401(k) with employer match
That can be a meaningful difference for a PA who wants flexibility without feeling like they’re cobbling together the basics on their own.
One of the reasons I chose CompHealth is that I’m an employee as opposed to an independent contractor.
“They’ll keep those benefits for 30 days in between assignments, which gives me time to travel and do other things. You also feel like you’re a part of a team and have company resources behind you and a group that’s supporting you.”
More than just a paycheck: Learn more about the benefits CompHealth offers
What’s covered and what you should plan for
One of the smartest things a PA can do before accepting an assignment is ask exactly what’s covered and what isn’t.
Areas to clarify include:
Travel to and from the assignment
Housing or housing stipend
Rental car or local transportation
Licensing fees
Credentialing support
Malpractice coverage
Health benefits eligibility
Retirement benefits
Even when an agency provides strong support, it helps to know what your own budget may still need to cover.
Flexibility isn’t just a buzzword
For many PAs, control over your schedule is one of the biggest benefits.
Locums can give you the ability to take time between assignments, choose where you want to go next, and build more intention into your year. That can be especially valuable if you’re burned out, balancing family priorities, or simply tired of feeling like you have no room to breathe.
Being a locum, I’m able to step back and plan things. I can take a little more time off and a little more time for me.
For some PAs, that kind of autonomy is just as important as the pay.
“I don’t know many jobs in the medical field where you can take a month off and not have to ask anyone for that time off. That’s pretty special,” says Raehl.
How locums can affect family life and work-life balance
Flexibility sounds appealing in theory, but it can also raise practical questions. What if you have kids? What if you’re caring for a parent? What if you want more control over your calendar but less disruption overall?
That’s where it helps to get specific. For some PAs, locums means building work around family schedules and major life events. For others, it’s choosing assignments closer to home or avoiding work that spills into evenings and weekends.
The real benefit isn’t that locums looks the same for everyone. It’s that it can be shaped around what matters most to you.
New places, broader experience
Locums can open the door to new locations while helping you build a more diverse clinical background.
The biggest benefit is that it affords you experience across different practices and locations. It gives you exposure to different ways of doing the same work, and that’s incredibly valuable.
For some PAs, that means traveling to parts of the country they’ve never lived or worked before. For others, it’s an opportunity to stay closer to home while still experiencing different practice settings, patient populations, and care models.
Along the way, many PAs build new skills, gain confidence in unfamiliar environments, and expand the range of cases they’ve managed. Over time, that experience also brings perspective—helping them get clearer on the kind of culture, leadership, and workflow they want.
That clarity can be valuable whether you stay in locums long term or eventually return to a permanent role.
Locums or permanent: What’s right for you
If you’re weighing locums against a permanent role, consider the trade-offs among flexibility, compensation, and day-to-day experience.
Potential pros
Higher hourly earning potential
More control over schedule and time off
Geographic flexibility
Exposure to new teams and practice environments
A way to reduce burnout or reset your career path
A chance to be compensated more directly for the hours you work
Professional variety
Potential cons
Credentialing and licensing can take time
New environments require adaptability
Some assignments may feel less predictable than a long-term role
Away-from-home assignments can feel isolating for some clinicians
Breaks between assignments require planning
You may need to be more intentional about budgeting and scheduling
When locums may make more sense than a permanent role
Locums may make more sense if you:
Want more flexibility and less long-term commitment
Interested in exploring a new region or practice setting
Want a reset without leaving clinical work
Prefer variety
Value being paid hourly for the work you do
A permanent role may make more sense if you:
Want a fixed team and predictable year-round schedule
Strongly value routine and continuity
Prefer a workplace where long-term relationship-building is a major priority
Don’t want to manage any level of transition between roles
Questions to ask before deciding whether locums is worth it for you
Am I drawn more to pay, flexibility, travel, or variety?
How important is predictability to me?
Would I feel energized by change, or drained by it?
Do I want to work continuously, or build in time off?
What would I need in place to make this feel financially and personally sustainable?
The bottom line
For many PAs, locum tenens is worth it because it offers higher pay potential, more flexibility, and meaningful support without giving up benefits. It isn’t the right fit for everyone, but it’s far more stable and practical than many people assume.
Go back to part one: What is locum tenens, and how do I get started?
Interested in learning more about locum tenens opportunities? We can help you find your first assignment. Give us a call at 800.453.3030 or view today’s locum tenens job openings.