Locum tenens has long been recognized for offering physicians freedom and flexibility, but it can also offer competitive compensation. Whether you’re looking to supplement your income, bridge the gap between full-time roles, or build a career entirely around temporary assignments, locum tenens work can offer competitive pay and meaningful control over your schedule.
But how does locum tenens pay actually work? Here, we cover how locum tenens compensation is structured, the factors that influence rates, and how working through a locum tenens agency affects your earnings.
What locum tenens means and why physicians choose it
Locum tenens describes physicians who temporarily fill in for other providers. Since the 1970s, when CompHealth pioneered the concept of bringing doctors to underserved regions, locum tenens has evolved into a mainstream career path for physicians at every stage of their practice.
Some doctors take locum tenens assignments between permanent jobs or fellowships, while others work full-time locum tenens for years at a time. The reasons for working locum tenens vary:
- More control over schedule
- The chance to travel
- Better work-life balance
- Opportunities to earn more—and better—pay
“Locum tenens gave me the freedom to design my own schedule and still maintain my income,” says Dr. Fuat Bicer, a hospitalist who transitioned from permanent employment to full-time locums work. “I realized I could work fewer weeks in a year and earn the same, or even more, than I did in my full-time job.”
Working as an independent contractor
Unlike employed physicians who receive a set salary and a W-2 tax form, locum tenens physicians are independent contractors who work under 1099 agreements with staffing agencies. This means they’re paid an hourly or daily rate directly by the agency rather than the facility where they are assigned.
Most locum tenens physicians are paid weekly or biweekly by direct deposit after submitting timesheets or logging hours through an online portal. For example, CompHealth locum physicians enter their time through the MyCompHealth mobile app or online portal, where they manage the details of their current and future assignments, and are paid weekly via direct deposit.
Some assignments also include completion bonuses or higher rates for weekend, holiday, or overnight shifts.
What determines how much you earn?
Locum tenens pay for physicians varies widely depending on specialty, location, demand, and shift type.
Specialists in high-demand fields (like anesthesiology, cardiology, and emergency medicine) tend to command higher hourly rates. But even in primary care, physicians often earn more per hour than their permanently employed counterparts.
Key factors that influence pay include:
- Specialty demand: High-need specialties may pay up to $300-$500 per hour.
- Location: Rural and underserved areas often pay higher rates to attract physicians.
- Shift type and workload: Call coverage, night shifts, and holiday assignments typically include premium pay.
- Experience and flexibility: Physicians who can start quickly, take on-call shifts, or adapt to different Electronic Medical Record (EMR) systems may earn more.
“Hospitals really appreciate locums who are dependable and willing to step in when coverage is needed,” says Dr. Bicer. “If you can travel or take on the harder-to-fill shifts, you’ll always be in demand, and often get better pay for it.”
Where can you earn the most? See this year's highest-paying states for locums
Average locum tenens pay rates by specialty
While rates fluctuate by region and demand, data from Locumstory’s Trends by Specialty tool shows just how competitive locum tenens pay can be.
In many cases, the hourly rates translate to annualized incomes that exceed those of full-time salaried physicians, and even more so when you consider the shorter assignments, travel stipends, and covered expenses that come with locum tenens work.
The advantages of working with an agency
While it’s possible to negotiate locum tenens jobs directly with hospitals, most physicians partner with a locum tenens staffing agency to handle the logistics. Reputable agencies like CompHealth, Global Medical Staffing (GMS), and Weatherby Healthcare not only help physicians find assignments but also negotiate rates, arrange travel and housing accommodations, and provide malpractice insurance coverage.
“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.’”
Working through an agency can slightly reduce your take‑home pay compared to contracting directly with a facility, but it also saves countless hours of paperwork and reduces logistical risk. Agencies handle negotiations and ensure all arrangements are set before you arrive, allowing you to focus on providing care, learning a new workplace culture, and enjoying yourself.
Locum tenens emergency medicine physician Dr. Russ Reinbolt appreciates CompHealth's personalized support, smooth logistics, and a team that truly advocates for you.
What agencies typically cover (and what they don’t)
One of the most significant benefits of partnering with a locum tenens agency is that most provide comprehensive logistical and financial support during your assignment. Typically, agencies cover:
- Travel and housing: Flights, rental cars, and accommodations are arranged and paid for by the agency. Short-term assignments typically include hotel lodging; for longer assignments, you may live in extended-stay apartments.
- Malpractice insurance: Most agencies include malpractice coverage, often with tail protection. Both CompHealth, GMS, and Weatherby provide $1M/$3 coverage limits and lifetime tail coverage.
- Credentialing and licensing: Agencies have in-house teams that help physicians obtain or renew state licenses, often paying upfront for licensing fees.
- Per diem and reimbursements: Many agencies reimburse meals and incidentals, and cover costs like mileage, parking, or baggage fees.
However, because locum tenens physicians are independent contractors, they’re responsible for their own health insurance, retirement contributions, and taxes. Some locum tenens physicians buy coverage through the marketplace or use a spouse’s plan; others build those costs into their rates.
“I looked at it as an opportunity to learn,” says Dr. Singh.
What are the benefits of working with an agency? Here are 7 reasons not to go it alone
How agencies make money
Locum tenens agencies are compensated by the healthcare facilities that hire them, not by the physicians they place.
The agency bills the facility a set rate for each hour the locum works, then pays the physician a portion of that rate. The difference covers the agency’s costs for credentialing, licensing, travel, housing, insurance, and recruiter support.
Working with a locum tenens agency can help ensure a smoother experience, since agencies have an incentive to keep providers satisfied. They manage all the administrative details, including credentialing, contracts, and logistics, so you can focus on practicing medicine rather than paperwork.
Common misconceptions about locums agencies: Debunking the myths about working with an agency
Taxes and financial planning for 1099 physicians
One area of potential confusion is how taxes work for locums tenens physicians. Because locum tenens physicians are contractors, taxes are not withheld from their paychecks; individuals are responsible for making estimated quarterly tax payments.
While that adds a bit of administrative responsibility, it also opens the door to more deductions. As independent contractors, physicians can write off eligible “ordinary and necessary business expenses” such as travel, continuing medical education, licensing, and home office costs.
Common deductions include:
- Home office or workspace costs
- Vehicle mileage and travel expenses
- Continuing medical education (CME) courses, conferences, and professional dues
- Licensing and credentialing fees
- Cell phone and internet expenses
Financial advisors recommend setting aside roughly 30 - 35% of income for taxes and working with an accountant familiar with 1099 income.
Dr. Simrah Singh, a neurologist, notes that working with an accountant helps simplify her taxes. “And you know, it is really not hard. It just takes a little more time. I also use an accountant, and have them do it for me,” she says.
How physicians use locum tenens to build income and pay down debt
For many physicians, locum tenens isn’t just a career move; it’s a financial strategy. Working locum tenens full-time or alongside a permanent job can accelerate debt repayment, especially for those tackling medical school loans.
Pediatrician Dr. Trevor Cabrera paid off $315,000 in medical school debt in just three years by working full-time as a locum tenens physician.
“My monthly locum tenens income alone is close to double that of all traditional jobs I could have taken, and more than 50% of my yearly income as a resident. I’m doing what I love as a pediatrician, yet I'm earning a salary comparable to that of an orthopedic surgeon.
“After accounting for my taxes as an independent contractor, shifting some money into retirement funds and savings, and setting aside a wellness fund, the rest went straight to my loans—roughly 40% of my monthly adjusted gross income. I definitely work a lot, giving myself roughly four to six days off per month, but by making loan repayment a priority, I’m watching the total figure dwindle at an ever-increasing rate.”
Other physicians use locum tenens as a bridge to semi-retirement.
“I plan on working locum tenens until I retire. We have some debts we want to pay off in the next few years, and after that, the idea is to work two weeks on, two weeks off, enough to pay off the mortgage and put some money away,” explains Dr. Robert Brenner, a locum tenens gastroenterologist. “I don’t plan to return to a permanent job like I had for the rest of my career. As long as locums works for me, I’ll keep doing that.”
The bottom line: Locum tenens provides flexibility and earning power
Locum tenens pay is not one-size-fits-all, but it consistently rewards flexibility, skill, and adaptability.
Whether you are filling in at a rural hospital or taking a long-term assignment at an academic center, working with a reputable agency can simplify the process, ensure fair compensation, and offer support every step of the way.
“I have more time to pursue my other passions. The more that I can improve the way I take care of myself, the more I can dedicate more quality time to my patients,” he continues.
Interested in exploring locum tenens work?
Locum tenens is an excellent way for physicians to gain more independence and flexibility in their careers while earning a competitive wage.