What Are the Highest Paid Nurse Practitioners?
What Are the Highest Paid Nurse Practitioners?

What Are the Highest Paid Nurse Practitioners?

When a nurse looks to choose a specialty as a nurse practitioner, it is good to know which would be the highest paid one. It might make a difference in the specialty you choose for your career. There are a number of options, and each one is as important to the healthcare system as another.  Even if you feel you know what your ideal job would be, it could be a good decision to at least look over some of the highest paying specialties for a nurse.

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Nurse Practitioner Certified Salary

Here are 5 of the nurse practitioner specialties with the highest salary. Keep in mind each nurse practitioner salary is an annual estimate and can vary from region to region.  An average annual nurse practitioner salary can also fluctuate based upon production bonus opportunities as well.  The highest annual salary compensation is as follows:

  • Certified registered nurse anesthetist – this nurse practitioner specialty is the highest paying in terms of annual median income. Hourly wage can be as high as $87 an hour, with an annual salary between $166,000 and $181,000. Competition is very high for this highest paying nursing position.
  • Psychiatric mental health nurse practitioner – the pay scale for this specialty annually is around $107,000 to $139,000. The amount can differ from state to state. Some psychiatric mental health nurse practitioners can prescribe medications.
  • Pediatric nurse practitioner – the specialty of pediatric nurse ranges about $131,000 a year. Although the salaries start to be in a similar range with other specialties, the duties can be quite different. For pediatric nurses, however, the starting salary may be a bit higher than others.
  • Orthopedic nurse practitioner – this specialty has a $123,000 pay range. It is a field that can be very rewarding as you help patients recover from bone and muscle injuries.
  • Urology nurse practitioner – a specialty that is an annual under served area for nurse practitioners, a urology nurse practitioner makes about $120,000 a year.

Nurse Practitioners Other Well-Paying Programs (Including Family Nurse and Critical Care)

Here are some more health care specialties for a nurse practitioner that offer excellent annual pay per year.

  • General nurse practitioner — $111,000
  • Certified nurse midwife — $108,000
  • Pain management nurse — $101,000
  • Family nurse practitioner — $98,000
  • Critical care nurse — $74,000

Is Pursuing a Nurse Practitioner Career Worth It?

Is it worth it to work to get your nurse practitioner employment contract properly reviewed and negotiated? It is always worth it to negotiate a nurse contract so you are sure to have a profitable and productive relationship with your new employer. The overall goal is to be very confident of the nurse contract details and that you won’t be hurting yourself in the future with decisions finalized in the nurse contract. Never settle. Know your rights and ensure you keep them.

RN to Nurse Practitioners Know Your Career Salary Worth

As a nurse you are a valuable asset to any organization. Your knowledge and skill is in high demand. As an employee of a clinic or a hospital, you contribute to them turning a profit, and you should be compensated fairly.

Health Care Contract Salary Negotiation and Nurse Practitioner Salary

Negotiating a nurse contract is important to ensure you have clarity on how your potential future employer will reward your performance; not just now but in the future as well. Realize that emotion should stay out of it, and you should maintain a calm and focused attitude. You are simply having a conversation. Even better than embarking upon this yourself — have an attorney do the review and negotiation for you. Someone with experience can have better judgement as to what should be included in the nurse contract.

Nursing Health Care Contract Requirements

There are a number of issues within a nurse contract that need review and possibly negotiation. These include:

  • Salary – you should know the average amount a nurse is paid hourly and/or annually. When you have this average, you will know how to consider your potential employer’s offer.
  • Bonuses – the nurse contract should state how bonuses will be paid and when. It should be well-defined. Don’t let your employer get away with making empty promises.
  • Flexibility of Schedule – depending on your lifestyle and what needs you have regarding scheduling, you will need to ensure it is clearly laid out in the nurse employment contract.
  • Vacation Time – most employers already offer about two or three weeks of paid vacation time. You might want to negotiate for a few days more. If no paid vacation is offered, then ensure that the flexibility of your schedule allows for time away.

There are other points to review such as continuing education, insurance benefits, and retirement. A thorough nurse contract review and effective negotiation puts your career on the right track.

Should an NP take a position as an Independent Contractor?

If a nurse practitioner (NP) is offered a position as an independent contractor, should she agree to take it? There are pros and cons to any situation, so knowing details allows the nurse to make a good decision. A nurse might see employers offering as much as $20 an hour more for a nurse to work as a 1099 independent contractor, but is it as beneficial as it looks?

How Annual Taxes Work as an Independent Contractor for Nursing

Taxes are handled differently with regular employees vs independent contractors. When a nurse are a W-2 employee, the nurse must state and federal taxes, social security taxes, etc. come out of the NP’s paycheck. This doesn’t happen with a 1099 position. No taxes are deducted from the nurse practitioner’s pay. Come tax time, the nurse practitioner is responsible for paying income tax, social security tax, Medicare tax as well as a self-employment tax. Social security and Medicare taxes will be twice as much, since the nurse practitioner doesn’t have an employer paying half. Although it looks as if the nurse practitioner is being paid a lot of money at pay time, the nurse can’t forget that they will still owe taxes at tax time.

Demanding More Pay Per Hour (or Salary) as a Nursing Independent Contractor

When working as an independent contractor, the nurse practitioner can demand more money. The employer doesn’t have to shoulder the tax burden, so should be able to pay the nurse quite a lot more. Since the nurse also won’t receive any benefits as a 1099 contractor, the NP’s pay should make up for that. The nurse can figure that they can ask for ten to twenty percent more than standard pay for a W-2 employee.

Job Outlook For a Self-Employed Health Care Nurse?

Some people get confused as to whether an independent contractor is considered self-employed. In fact, they are the same thing. In fact, independent contractors often go by other names, such as freelancers, contract workers, small business owners, and more.

When being offered a job as an independent contractor and receiving a nurse contract to sign, it is wise to have the nurse contract reviewed by an attorney who is trained to handle these types of things. This way the nurse can be sure that the nurse contract is a binding legal document that will benefit the nurse in important ways.

Nurse Practitioners Contract Checklist

Every nurse practitioner employment contract is unique.  However, nearly every nurse practitioner contract for health care professionals should contain several essential terms.  If these essential terms are not spelled out in the employment contract, disputes can arise when there is a disagreement between the employer and employee as to the details of the specific term.  For instance, if the nurse is expecting to work at the practice Monday through Thursday and the employer is expecting the provider to work Monday through Friday, but the specific workdays are absent from the contract; who prevails?  Spelling out the details of your job is crucial to avoid conflicts during the term of your employment.  Below is a checklist of essential terms that employment contracts should contain (and a brief explanation of each term):

  1.  Services Offered: What are your patient care duties? Are providers given time for administrative or planning tasks?
  2. Patient Care Schedule: What days and hours per week are providers expected to provide care?
  3. Locations: Which facilities will you be scheduled to provide care at (outpatient clinic, surgical sites, in-patient services, etc.)?
  4. Outside Activities: Are you permitted to pursue moonlighting or locum tenens opportunities? Do you need permission from the employer before you accept those positions?
  5. Physician Oversight: If physician oversight is needed due to state law; who will be the supervising physician?
  6. Call Schedule: How often are you on call (after hours office call, hospital call (if applicable)?
  7. Electronic Medical Records (EMR): What EMR system is used? Will providers receive training prior to providing care?
  8. Base Compensation: What is the annual base salary? What is the pay period frequency?  Does the base compensation increase over the term of the Agreement?
  9. Productivity Compensation: If there is productivity compensation; how is it calculated (wRVU, net collections, encounters, etc.)?
  10. Benefits Summary: Are standard benefits offered: healthcare, vision, dental, life, disability, retirement, etc.?
  11. Paid Time Off: How much time off is offered? What is the split between vacation, sick days, CME attendance and holidays?
  12. Continuing Medical Education (CME): What is the annual allowance for CME expenses and how much time off is offered?
  13. Dues and Fees: Which business expenses are covered in the contract (licensing, DEA registration, privileging)?
  14. Relocation Assistance: Is relocation assistance offered? What are the repayment obligations if the Agreement is terminated prior to the expiration of the initial term?
  15. Signing Bonus: Is a signing bonus offered? When is it paid?
  16. Professional Liability Insurance: What type of professional liability insurance is offered: claims made, occurrence, self-insurance?
  17. Tail Insurance: If tail insurance is necessary, who is responsible to pay for it when the Agreement is terminated?
  18. Term: What is the length of the initial term? Does the Agreement automatically renew after the initial term?
  19. For Cause Termination: What are the grounds for immediate termination for cause in the Agreement for providers?
  20. Without Cause Termination: How much notice is required for either party to terminate the Agreement without case?
  21. Post Termination Payment Obligations: Will you receive production bonuses after the Agreement is terminated?
  22. Non-Compete: How long does the non-compete last and what is the prohibited geographic scope?
  23. Non-Solicitation: How long does it last and does it cover employees, patients, and business associates?
  24. Notice: How is notice given in the contract? Contact via email, US mail, etc.? Does the practice and their lawyer have to be notified?
  25. Assignment: Can the Agreement be assigned by the employer?
  26. Alternative Dispute Resolution: If there is a conflict, will mediation or arbitration process be utilized? Who decides what attorney oversees the process? What litigation is allowed? Who is responsible for attorney’s fees?

Breaking a Nurse Practitioner Contract with a Non Compete

Non compete agreements were originally considered as restraints of trade, and thus were invalid on the grounds of public policy at common law; however, many restraints of trade incident to employment agreements were upheld based on the rule of reason.  Thus, restrictive covenants not to compete after termination of employment are generally enforceable as long as it is reasonable.  However, there are a few states which prohibit health care provider non compete agreements.  Please check your state laws for nurse practitioner non compete agreements to see what the specific rules for your state are.  The general test for reasonableness of a non-competition clause holds that on termination of employment, a covenant  which restrains an employee from competing with his former employer is termed reasonable if:

  • The restraint is not more than required for protecting the employer,
  • It does not inflict any untold of hardships to the employer, and
  • The restraint is not injurious to the public.

Nurse Practitioners Reasonableness of Non Compete

For instance, in Ohio, a non-competition clause was unreasonable when it was noted that a provider’s sub-specialty was uncommon, and that it would be harsh if the restrictive covenant was enforced as the hospital where he was precluded from practicing was only one of the few institutions in the area where he could practice his specialty. Thus, in Ohio, covenants restraining providers from competing with his employer on termination of employment is considered unreasonable if it inflicts untold of hardship on the physician, is injurious to the public, if the demand for the NP’s medical expertise is important for the community people and if the services are important for the health, care and treatment of public.  However, non-competition clauses for nurse practitioners, in general, are enforceable as long as they protect some of the employer’s legitimate interests.

Nurse Practitioners Contract Lawyer

For nurse practitioners, it isn’t always the money that guides someone into choosing a field or specialty. It is often the service and assistance one can be to the patients who need someone to turn to and who can care for them effectively. No matter which specialty you choose, you will be of vital service to people in many ways.