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For You News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point Specialty: Nurses Allergy & Immunology Anesthesiology Business of Medicine Cardiology Critical Care Dermatology Diabetes & Endocrinology Emergency Medicine Family Medicine Gastroenterology General Surgery Hematology - Oncology HIV/AIDS Hospital Medicine Infectious Diseases Internal Medicine Multispecialty Nephrology Neurology Ob/Gyn & Women's Health Oncology Ophthalmology Orthopedics Pathology & Lab Medicine Pediatrics Plastic Surgery Psychiatry Public Health Pulmonary Medicine Radiology Rheumatology Transplantation Urology Medical Students Nurses Pharmacists Residents Today on Medscape Edition: ENGLISH DEUTSCH ESPAÑOL FRANÇAIS PORTUGUÊS UK Log In Sign Up It's Free! 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Log out Cancel MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information * 0Read Comments * Share X Facebook Twitter LinkedIn Email * 1 24 Swipe to advance 1 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information 2 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Practicing advanced practice registered nurses (APRNs) in the United States participated in an online survey about annual earnings as part of a larger survey that included registered nurses (RNs) and licensed practical nurses (LPNs). After a recruitment period lasting from May 17 through August 2, 2021, a total of 3039 APRNs met the screening criteria and completed the survey. This group includes 380 certified registered nurse anesthetists (CRNAs), 2016 nurse practitioners (NPs), 505 clinical nurse specialists (CNSs), and 408 nurse midwives (NMs). This report summarizes survey findings from those APRNs. Where applicable, we compare findings from the current year with those of last year's compensation survey. A separate report describes the survey findings from RNs and LPNs. (Note: Although this survey was conducted in 2021, respondents were asked to report earnings from 2020. Except where noted, annual gross income figures are averages, based on reported wages of full-time APRNs.) 3 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Among total APRNs who are not currently employed and therefore did not qualify for the survey, 24% cited COVID-19 as the reason they were not working; 20% retired earlier than planned, 1% were furloughed, and 3% were laid off or fired. 4 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information The primary work setting of APRNs differs by type of APRN. For example, the most frequent work setting for CRNAs, CNSs, and NMs is the acute care hospital. In contrast, NPs are most often found in either hospital-based or non–hospital-based outpatient settings or clinics. 5 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Compensation for all full-time APRNs increased in 2020 over the previous year, except for NMs, whose annual gross incomes were on average unchanged. CRNAs still earned significantly higher wages in 2020 than other APRN groups. Financially, becoming an APRN is a good move. Overall, the annual incomes reported by full-time APRNs were higher than the average earnings ($83,000) of full-time RNs. 6 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information The largest group of APRNs in our survey are NPs, and based on 2020 earnings, the highest annual incomes were reported by NPs who worked in acute care hospital settings, followed by hospital-based outpatient settings or clinics. 7 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Advanced practice certification is a requirement for NP practice in the United States. A majority (63%) are certified as family NPs, and another 11% are adult-gerontology primary care NPs. When it comes to income, however, the most well-paid in this survey were the psychiatric/mental health NPs. Family NPs showed an increase in compensation from 2019. 8 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Most APRNs work full time (at least 36 hours weekly). Among APRNs, CRNAs were the most likely to work full time (85%) and CNSs the least (73%). In years past, we have reported hourly rates of pay for APRNs who worked both full-time and part-time positions. This year, however, we had sufficient data to report the hourly rate of pay only for NPs, which was $63 in 2020 for both part-time and full-time employees. 9 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Differences in annual earnings varied according to the type of APRN employment. Those employed by private NP practices generate less income than those employed by a medical group or hospital or those who are self-employed/independent contractors. Overall, annual income increased among APRNs employed by a medical group or hospital compared with last year. 10 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Relatively few APRNs own their own practices. CRNAs were most likely among all APRNs to do so. Overall compensation for APRNs who own their own practices in 2020 was $158,000 compared with $140,000 in 2019. 11 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Whether APRNs practice independently or under a collaborative practice arrangement with a physician varies with type of ARPN. A majority of APRNs report practicing independently. CNSs were most likely to report having a formal collaborative practice agreement with a physician. 12 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information The minimum entry-level educational requirement for APRNs in the United States is the master's degree. In this year's survey, 81% of all APRNs held a master's degree and 17% held a doctorate (PhD or DNS). On average, among NPs, those with a doctorate make about 5% more than those with a masters. 13 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Among survey respondents, men represented about 37% of CRNAs and substantially smaller proportions of NPs (9%), CNSs (7%), and NMs (1%). Male CRNAs and NPs (the only groups with enough respondents for analysis) earned significantly more than females with the same roles. The annual gross income of male CRNAs and NPs exceeds that of their female counterparts by about 11%-12%. 14 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information We don't know why men in nursing, even those in advanced practice roles, earn more than women, but our survey provides some potential clues. Men were more likely than women to work in higher-wage settings, such as inpatient or outpatient acute care hospital settings. Men are also more likely to earn supplemental income and to own their own practices, findings that were similar to last year's report. 15 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information The annual earnings of all APRNs increase with more years of practice. However, as we've seen in past surveys, these increases appear to level off at about 20 or more years of practice. This might represent a salary cap. APRNs who have been in practice 21 years or longer reported earning significantly more ($129,000) than they did the previous year ($124,000). 16 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Once again, we saw a distinct pattern in regional earnings for APRNs. Those employed in the Pacific region of the United States (California, Oregon, Washington, Alaska, and Hawaii) reported the highest incomes, whereas APRNs in the East South Central region (Tennessee, Kentucky, Mississippi, and Alabama) reported the lowest. Of note, compared with mean annual earnings, the median earnings were substantially lower and might more closely reflect actual earnings by APRNs in these regions: * New England: $122K * Mid-Atlantic: $118K * South Atlantic: $110K * East North Central: $111K * West North Central: $113K * East South Central: $104K * West South Central: $120K * Mountain: $118K * Pacific: $140K (Note: These incomes are not adjusted for cost of living.) 17 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information The earnings of NPs, the largest group of APRNs, followed the same pattern as the overall APRN regional earnings. NPs in the Pacific region earned the most, and those in the East South Central and South Atlantic regions earned the least. NPs in both the highest- and lowest-paying regions experienced significant increases in compensation compared with last year. Incomes for NPs in the Pacific region increased from $128,000 to $136,000 and incomes in the East South Central region increased from $98,000 to $105,000. The median annual earnings were lower than the averages for these regions: * Mid-Atlantic: $117K * South Atlantic: 106K * East North Central: $107K * West North Central: $108K * East South Central: $102K * West South Central: $115K * Mountain: $115K * Pacific: $137K * New England: Number of respondents insufficient for analysis 18 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information The majority of APRNs work in urban or suburban settings. We had sufficient data to report earnings by type of community only for NPs. As shown here, annual earnings for NPs are highest in urban settings and lowest in rural settings. 19 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Relatively few APRNs (< 10%) belong to unions or collective bargaining units. However, the average annual incomes of APRNs who were members of unions or collective bargaining units ($136,000) were higher than those of nonmembers ($127,000). Non-union APRNs earned significantly more compared with the previous year ($123,000). 20 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information The survey asked APRNs whether they had experienced a decrease, an increase, or no change in earnings from the previous year. At least half of APRNs saw an increase in their income in 2020 compared with 2019. Between 29% and 36% said it remained the same, and between 12% and 20% reported that it decreased. It isn't possible to determine from our data whether higher earnings reflect true wage growth. Higher earnings might also be the result of increases in cost-of-living compensation. 21 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information Inevitably, the pandemic made an impact on the earnings of many APRNs. Although few APRNs were laid off, reductions in work hours, temporary furloughs, and suspension of annual raises probably contributed to a loss income for certain APRN groups. Many CRNAs, for example, experienced reduced work hours while elective surgeries were postponed. NMs were least likely to report an impact of the pandemic on their livelihood. 22 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information More than half of all APRNs reported that they feel their compensation is fair, and this proportion dropped over the previous year, from 63% in 2019 to 57% in 2020. CRNAs (the highest earners) most often reported feeling fairly compensated. Satisfaction with annual earnings did not differ by gender, age, union membership, or other variables. 23 of 24 Scroll MEDSCAPE APRN COMPENSATION REPORT 2021 Laura A. Stokowski, RN, MS; Sarah Lesser; Mary McBride; Emily Berry | December 3, 2021 | Contributor Information 24 of 24 RELATED CONTENT ON MEDSCAPE RELATED CONTENT ON MEDSCAPE Start MEDSCAPE APRN COMPENSATION REPORT 2020 Find out how much APRNs are being paid and whether their earnings are static or increasing.Medscape Features Slideshow, Nov 2020 MEDSCAPE RN/LPN COMPENSATION REPORT, 2021 All Slideshows 1 24 Next 0Read Comments Facebook Twitter LinkedIn Email COMMENTS (0) 3090D553-9492-4563-8681-AD288FA52ACE Commenting is temporarily disabled while we upgrade this platform. Please bear with us as we are working to improve your experience. Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion. Return to Article Post as: Jeannine Runnels Jeannine R J R Close CONTRIBUTOR INFORMATION Laura A. Stokowski, RN, MS Editorial Director Medscape Sarah Lesser Manager, Market Research Medscape Mary McBride Director, Market Research Medscape Emily Berry Editor Medscape Close REFERENCES Close IMAGE ZOOM Close FEEDBACK Help us make Medscape the best clinical resource possible. Please use this form to submit your questions or comments on how to make this slideshow more useful to clinicians. Your Name * Your Email * Comment or Suggestion * (Limited to 1500 Characters) Send Thank you. Your feedback has been sent. Please do not use this form to submit personal or patient medical information or to report adverse drug events. You are encouraged to report adverse drug event information to the FDA. 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