Demand for nurse practitioners (NPs) is expected to remain exceptionally high in the next decade, with the Bureau of Labor Statistics estimating a much faster-than-average growth rate of 40% by 2033. This field has a lot to offer, including opportunities, job security, and a lucrative salary. But what specialty is the highest paid? And what other factors impact earnings potential?
Below, we cover the salaries of eight popular NP specialties from highest to lowest earning and offer other key insights into factors that can impact your income as an NP.
Our Editorial Process
This guide is written by a credentialed nurse and reviewed against source-of-truth references at least annually. Salary figures are verified directly from the Bureau of Labor Statistics May 2024 Occupational Employment and Wage Statistics release, supplemented by Payscale and ZipRecruiter for specialty-specific breakdowns the BLS does not publish separately. Specialty role definitions are verified against the American Association of Nurse Practitioners (AANP) and the relevant certifying bodies. Read our full editorial standards.
8 Highest-Paid NP Specialties (Ranked)
Median annual NP salary varies by approximately $35,000–$45,000 across primary NP specialties. The ranking below is based on Payscale and ZipRecruiter median wage data as of 2024, which provides the specialty-level breakdown the BLS national NP median ($129,210) does not split out separately. Practice setting, geographic market, and years of experience cause meaningful variation around these medians.
| Rank | Specialty | Median wage (2024) | Certifying body | Primary setting |
|---|---|---|---|---|
| 1 | PMHNP (Psychiatric-Mental Health) | ~$144,000 | ANCC | Outpatient psychiatry, telehealth, addiction medicine |
| 2 | NNP (Neonatal) | ~$135,000 | NCC | NICU, neonatal acute care |
| 3 | AGACNP (Adult-Gerontology Acute Care) | ~$130,000 | ANCC, AACN | ICU, hospitalist programs, specialty inpatient |
| 4 | FNP (Family) | ~$118,000 | ANCC, AANPCB | Primary care clinics, retail health, telehealth |
| 5 | AGPCNP (Primary Care) | ~$118,000 | ANCC, AANPCB | Adult primary care, internal medicine, geriatric practice |
| 6 | PNP-AC (Pediatric Acute Care) | ~$115,000 | PNCB | Pediatric ICU, complex chronic conditions |
| 7 | WHNP (Women’s Health) | ~$112,000 | NCC | OB/GYN practices, women’s health clinics, family planning |
| 8 | PNP-PC (Pediatric Primary Care) | ~$108,000 | PNCB | Pediatric primary care, school-based health clinics |
National BLS median for all NPs combined: $129,210/year (May 2024). Specialty-specific medians from Payscale/ZipRecruiter 2024 data. See methodology for source detail.
2026 Updates: NP Salary Trends
- BLS data refresh (May 2024 OES). National median NP wage is now $129,210; projected NP employment growth is 46% from 2023 to 2033 — updated upward from prior projections.
- PMHNP salary growth outpacing other specialties. Mental health workforce shortages and post-2020 telehealth expansion have driven PMHNP salaries up roughly 8–12% over the past two years, sustaining its #1 ranking and widening the gap to the rest of the field.
- Hospitalist NP demand sustaining AGACNP premium. Hospital systems are aggressively expanding AGACNP-led hospitalist programs to relieve physician workload, sustaining the acute-care salary premium of $10,000–$15,000 over primary care NP specialties.
- NNP supply remains tight. Specialized NICU training and a smaller program count keep NNP salaries near the top of the field. Neonatal subspecialty knowledge is hard to substitute, which preserves the wage premium.
- Geographic spread is widening. Coastal metropolitan markets (CA, MA, NY, WA) and Pacific Northwest pay 15–25% above the national specialty medians; rural and Southern markets often pay 10–20% below. The gap has widened with telehealth-anchored urban demand.
- DNP wage premium remains modest. The salary premium for DNP-prepared NPs vs MSN-prepared NPs in clinical roles remains small (~2–5%). Larger DNP premiums appear in nurse executive, faculty, and CNO roles. See our DNP vs NP comparison.
How We Ranked These Specialties
Salary rankings on this page combine three sources because the BLS does not publish a separate median wage for each NP specialty.
- BLS national median ($129,210, May 2024). The OES survey publishes a single national median for all nurse practitioners combined under SOC 29-1171. We use this as the denominator for percentage comparisons.
- Payscale specialty-level medians. Payscale collects self-reported salary data tagged by specialty. We use the most recent 2024 medians where Payscale’s sample size exceeds 200 reporting respondents per specialty.
- ZipRecruiter specialty-level medians. ZipRecruiter publishes specialty-tagged listing data. We cross-check against ZipRecruiter when Payscale’s sample is thin or when the two sources diverge by more than 5%.
Where Payscale and ZipRecruiter diverge meaningfully, we report the midpoint and note the spread. Subspecialty data (cardiology, orthopedic, oncology NP) comes from the same Payscale/ZipRecruiter pipeline and is presented as a separate section.
Salary figures are point-in-time snapshots from public 2024 data and should be confirmed against the most recent BLS, Payscale, or ZipRecruiter releases when making career decisions. Practice setting, geography, and years of experience cause variation that often exceeds the gap between specialty medians.
Psychiatric Nurse Practitioner (PMHNP)
Psychiatric Mental Health Nurse Practitioners are qualified to diagnose and treat mental illnesses and substance abuse problems. They can prescribe psychiatric medications and can even act as therapists or counselors.
PMHNPs can work with psychiatrists, in schools, or in community mental health centers. This specialty is one of the most in-demand and highest-paying, with an average yearly salary of around $155,846.
Neonatal Nurse Practitioners (NNP)
NNPs work exclusively with infants who are born prematurely or who have a congenital disability, illness, or other health condition at birth or soon after birth. Many NNPs work in neonatal intensive care units (NICUs), but they can also work in delivery rooms, emergency rooms, or outpatient clinics, managing follow-up care.
This specialty is one of the highest-paying, with NNPs earning an estimated $136,649 per year.
Family Nurse Practitioner (FNP)
FNPs provide a wide range of health services to patients of all ages, from infants to seniors. This specialty is one of the most popular, with FNPs playing a crucial role in addressing primary care gaps due to a national shortage of primary care physicians.
FNPs can work in both inpatient and outpatient settings, including doctors’ offices, clinics, hospitals, or surgery centers, and in some states, even open their own practices. Where an FNP works will play a role in their salary. On average, however, FNPs earn approximately $127,780 per year.
Women’s Health Nurse Practitioner (WHNP)
WHNPs specialize in reproductive and sexual health services, gynecological care, and reproductive system disorders. Many work in OBGYN offices, but they can also work in outpatient clinics, hospitals, or birthing centers. On average, a WHNP makes an annual salary of about $124,362.
Acute Care Pediatric Nurse Practitioner (PNP-AC)
PNP-ACs generally work in inpatient settings, like hospitals or emergency rooms, but they can also work in specialty clinics or other areas. These NPs are trained to care for pediatric patients with critical or acute healthcare needs, as well as those with complex chronic illnesses. They often care for patients who are facing life-threatening illnesses.
Due to the complexity of care delivered by these professionals, PNP-ACs are generally paid more than their primary care counterparts, earning around $119,900 and $140,724 annually.
Acute Adult–Gerontology (AGACNP)
Acute care AGNPs or AGACNPs typically work in hospitals and inpatient settings. Because they receive specialized training, they may also be qualified to work in emergency rooms and intensive care units. These professionals make more than their primary care counterparts and are likely to have an annual salary between $108,000 and $130,000.
Primary Care Pediatric Nurse Practitioner (PNP-PC)
PNP-PCs work primarily in outpatient settings, like clinics, doctors’ offices, urgent care centers, or schools, caring for patients from birth through young adulthood.
Many salary estimates cover pediatric nurse practitioners as a whole, primary care NPs generally make less than their acute care counterparts in any specialty. PNP-PCs are likely to make between $102,324 and $119,900 a year.
Primary Adult–Gerontology (AGPCNP)
Primary care AGNPs or AGPCNPs work with adults of all ages, from adolescents to seniors. They often work in outpatient settings, such as clinics or doctors’ offices, or in long-term care facilities, including nursing homes or memory care centers.
Because they work in primary care, AGPCNPs may make slightly less than AGNPs who work in acute settings. On average, they may earn between $88,000 and $108,000 a year.
What about subspecialities?
As you can see, the specialties listed above are population-focused; however, within these specialties are subspecialties. Training in a subspecialty can make an NP more of a specialist, which can significantly increase their salary.
Qualifying for a subspecialty varies from one to the next. Generally, NPs must have significant experience working in that area and pass a certification exam; however, some universities may offer subspecialty tracks that can help NPs meet these requirements while they are still in school.
It’s worth noting that you don’t have to have a subspecialty as an NP. Still, many times, NPs may find that they are drawn to a particular type of patient or have an innate understanding of or interest in a specific area of medicine. For these nurses, a subspecialty can be a way to focus on a genuine passion and substantially increase salary.
Here are some of the subspecialties available for NPs, with the highest-paid specialties listed first.
Orthopedic NP Certification
Orthopedic specialist NPs manage care for patients with musculoskeletal conditions. They may work in sports medicine clinics, surgery centers, or rehab facilities. This certification is offered by the Orthopaedic Nurses Certification Board. According to Glassdoor, an orthopedic nurse practitioner (NP) earns approximately $171,000 per year.
Cardiology NP Certification
Cardiac NPs make an average of $144,905. They work with patients with cardiovascular diseases, like heart failure or coronary artery disease, or other forms of heart disease. They often work in hospitals on cardiac care units or in outpatient cardiology offices. This certification is offered by the American Board of Cardiovascular Medicine.
Emergency Care NP Certification
This subspecialty is for NPs who work in emergency medicine, whether that’s in an emergency room in a hospital or part of a disaster response team. The American Academy of Nurse Practitioners National Certification Board offers this certification. According to ZipRecruiter, emergency care NPs make about $134,369 a year.
Nephrology NP Certification
This subspecialty, offered by the Nephrology Nursing Certification Commission, focuses on kidney health. Most NPs with this certification work in doctors’ offices or hospitals, earning an average salary of $130,295 a year.
Hospice and Palliative Care NP Certification
NPs with hospice and palliative care certification provide end-of-life care and help patients and their families navigate serious illnesses. They can work in patient homes, long-term care facilities, or hospice centers and are credentialed by the Hospice and Palliative Credentialing Center. According to Glassdoor, these professionals earn about $127,000 a year.
Oncology NP Certification
This subspeciality focuses on caring for patients with cancer. Oncology NPs can work in various facilities, including doctors’ offices, hospitals, infusion centers, and residential care facilities. The Oncology Nursing Certification Corporation offers this certification, and those in this profession earn a salary of about $123,000.
Other factors that can affect pay
There are several other factors that can impact NP pay, including those outlined below.
- Experience. As in any field, the more experience you have, the more you are likely to earn. After a certain period of time, though, the pay rate may plateau.
- Location. There are significant differences in NP pay across states nationwide. According to ZipRecruiter, NPs in Washington state earn an average of $147,571 per year, while those in Florida earn only $97,368. Keep in mind, though, that the cost of living also plays a factor.
- Practice setting. Specialty units in hospitals, such as ICUs or emergency rooms, are likely to pay the most because they require more specialized skills, whereas outpatient clinics, community health centers, and urgent care facilities typically pay less. In some states, NPs can practice independently and open their own practice, which can have high earning potential.
- Urban vs. Rural: Urban areas generally have larger hospital systems and specialty offices, and tend to pay more than rural areas, which are often home to smaller clinics, offices, and urgent care centers.
NP income by state
While it’s challenging to get a state-by-state breakdown of salary per specialty, knowing the average wage of NPs in each state can shed some light on where you may make the most money in any specialty.
According to ZipRecruiter, the top five highest and lowest paying states are as follows:
- Highest paying states for NPs: Washington ($147,571), Washington DC ($147,237), New York ($142,547), Massachusetts ($142,298), Alaska ($140,320)
- Lowest paying states for NPs: Louisiana ($111,418), Georgia ($110,019), Arkansas ($107,741), West Virginia ($100,870), and Florida ($97,368)
NP income by location
Again, it’s challenging to determine the salary per specialty in various locations, as every facility is different. However, in general, here are the highest and lowest paying facilities for NPs.
- Home health care settings: $148,960
- Private practice: $142,500
- Outpatient care centers: $134,030
- Psychiatric hospitals or substance abuse centers: $134,540
- Hospitals: $129,330
- Doctor’s offices: $121,880
Do NPs with a DNP make more than an MSN?
It’s difficult to say! MSN-prepared nurses make an average of about $106,000 a year, while those with a DNP make an average of about $115,000 a year. That’s a difference of $9,000, which may or may not seem like much when you consider the extra time and money it takes to complete a doctorate.
Additionally, it’s challenging to draw any conclusions from this information. These salary estimates consider all MSN and DNP-prepared nurses, not just those in NP roles, so they also include those in education or leadership, who are likely to make less than NPs.
That said, you may be wondering why one might pursue a DNP. Well, for one thing, there is a chance that a doctorate will become the required entry-level degree for NPs in the future. The American Association of Colleges of Nursing (AACN) and other organizations have proposed that NPs entering the field hold a doctorate by 2025. Another thing to consider is that DNPs may ultimately have more options. A DNP is a terminal degree, making you an expert in the field, which opens up doors for taking executive roles or learning policy reforms.
Which specialty should you choose?
Ultimately, money should not be the only factor in choosing a specialty. If you’re drawn to a particular patient population or have a passion for a specific area of care, a related specialty can be the best choice for you. That said, here are some final things to consider about the money factor.
- Consider the cost of living before relocating. NPs in Washington state make about $50,000 more a year than those in Florida, but that doesn’t mean you should pack up and move to the Pacific Northwest. The average rent of an apartment in Washington is $1,822 a month; in Florida, it’s $1,696. However, the average weekly grocery cost in Washington is $287.67; in Florida, it’s almost exactly the same at $287.27. So, do your research before relocating to ensure you’re making the most of your earnings potential.
- Take other benefits into account. Because NPs are in such high demand, it is worth considering other benefits that employers offer to be more competitive and attract the best applicants. Some employers may offer a lower wage but provide tuition reimbursement or cover your moving expenses. They may offer flexible scheduling, more comprehensive health insurance, higher retirement contribution matching, or more paid time off. In many cases, hourly wages or yearly salaries are not the whole story.
- Having a subspecialty can have a more significant impact on income than a DNP. If you have an MSN and want to advance your career, pursuing a DNP may seem like an obvious choice, but getting certified in a specialty may be a more lucrative decision. DNPs make an average of about $115,000 per year, whereas the lowest-paying subspecialty certification, Oncology NP, earns about $123,000.
What is the highest-paid NP specialty?
While many factors contribute to which specialty is the highest paying, a PMHNP is the highest paying, with an average salary of $155,846. That said, if you’re looking to make the most money you possibly can as an NP, consider a subspecialization as an orthopedic NP, whose average salary is about $171,000 a year.
Frequently Asked Questions About NP Salaries by Specialty
What is the highest-paid NP specialty?
Psychiatric-Mental Health Nurse Practitioner (PMHNP) is the highest-paid NP specialty in 2024 data, with a median wage near $144,000. Mental health workforce shortages and telehealth expansion have driven sustained PMHNP salary growth above other NP specialties.
Why don’t the BLS numbers match Payscale or ZipRecruiter?
The BLS Occupational Employment Statistics survey publishes a single national median ($129,210 in May 2024) for all NPs combined under SOC 29-1171, without a specialty-level breakdown. Payscale and ZipRecruiter collect self-reported salary data tagged by specialty, which is how we get specialty-specific medians. Specialty-level numbers will always be approximations relative to the BLS national figure.
Does AGACNP really earn more than FNP?
Yes, by approximately $10,000–$15,000/year on average. Acute care settings (ICU, hospitalist programs) command a wage premium over primary care, regardless of NP credential. AGACNPs working in academic medical centers and complex inpatient roles often earn $135,000–$150,000.
Do NNPs really earn near the top despite caring for the youngest patients?
Yes. Neonatal NPs work in NICU acute care environments, which carry the same kind of acute-care wage premium that AGACNPs receive. The NNP supply is also constrained by the small number of training programs, which preserves the wage premium through limited supply rather than through demographic demand alone.
How much does location affect NP salary?
Substantially. Coastal metropolitan markets (CA, MA, NY, WA) and Pacific Northwest cities pay 15–25% above national specialty medians. Rural and Southern markets often pay 10–20% below. The geographic spread within a single specialty often exceeds the gap between specialty medians, so location can matter more than specialty for total compensation.
Do DNPs earn more than MSN-prepared NPs?
In clinical NP roles, the salary premium is modest — typically 2–5% (a few thousand dollars per year). The DNP’s biggest financial returns appear in nurse executive, faculty, and CNO roles where doctoral preparation is preferred or required.
What’s the lowest-paid NP specialty?
Pediatric Primary Care NP (PNP-PC) is typically at the bottom of the ranking, with a median around $108,000. Pediatric primary care reimbursement runs lower than adult specialties, which suppresses the specialty’s median wage. School-based and underserved-area roles also pull down the average.
Should I choose an NP specialty based on salary alone?
No. Specialty fit (the patient population you’re drawn to, practice setting, daily work pattern) usually predicts career satisfaction and long-term tenure better than starting salary. Within any specialty, geography and years of experience drive substantial pay variation. A specialty fit you stay with for 15 years will out-earn a higher-paid specialty you leave after 4 years.