Nurse Practitioner On Call Pay Rates: A Comprehensive Guide

As a nurse practitioner, you provide vital healthcare services. Being on call allows you to assist patients even when you’re not at work. But how much should you get paid for being on call? What factors determine your on call pay rate?

This comprehensive guide will explain nurse practitioner on call pay, including average pay rates, how rates are determined, and tips for negotiating better pay.

Quick answer: Most nurse practitioners earn $2-5 per hour for being on call. Pay rates depend on your experience, specialty, employer, and local market rates. The highest on call pay is for emergency and specialty NPs.

What Is On Call Pay for Nurse Practitioners?

Being on call refers to the practice of being available to work outside of regular scheduled hours in case of emergencies or urgent situations. For nurse practitioners, being on call means they need to be ready to respond to patient needs and provide medical assistance, even during non-traditional working hours.

Definition of being on call

When a nurse practitioner is on call, they are essentially “on standby” and may be required to report to work within a specified timeframe if called upon. This can include being available by phone, receiving notifications through a pager or other electronic means, or physically staying at or near the healthcare facility.

It’s important to note that being on call does not necessarily mean that nurse practitioners are actively working during these periods. Instead, they are ready and prepared to provide care if and when needed.

Types of on call work

There are different types of on call work arrangements for nurse practitioners, which can vary depending on the healthcare facility and specific job responsibilities. Some common types of on call work include:

  • Scheduled on call: Nurse practitioners are assigned specific shifts or days when they are expected to be on call. This can be a regular part of their work schedule, with designated hours and compensation for being on call.
  • Unscheduled on call: Nurse practitioners may be required to be on call on an as-needed basis, without a pre-determined schedule. This can occur when there is a shortage of staff or during busy periods when extra support is needed.
  • Rotating on call: Nurse practitioners take turns being on call with other healthcare professionals, sharing the responsibility of being available outside of regular working hours. This allows for a fair distribution of on call duties among the team.

Each type of on call work has its own considerations, including compensation rates, expectations for response time, and the impact on work-life balance. It is essential for nurse practitioners to be familiar with their specific on call arrangements and understand the terms and conditions associated with their on call pay.

For more information on nurse practitioners and on call pay, you can visit for valuable resources and guidelines provided by the American Nurses Association.

Average Nurse Practitioner On Call Pay Rates

When it comes to on-call pay rates for nurse practitioners, several factors come into play. The average pay can vary based on experience level, specialty, and geographic location. Understanding these variables can help nurse practitioners negotiate fair compensation for their on-call duties.

Pay by Experience Level

The level of experience a nurse practitioner has can impact their on-call pay rate. Generally, more experienced nurse practitioners command higher rates. According to data from the Bureau of Labor Statistics, the median annual wage for nurse practitioners in 2020 was $111,680.

However, this figure can vary based on the number of years of experience. Nurse practitioners with several years of experience may earn significantly higher than the median wage, while those who are just starting their careers may earn less.

Pay by Specialty

The specialty in which a nurse practitioner works can also influence their on-call pay rate. Specialties such as acute care, emergency medicine, and critical care tend to have higher pay rates due to the demanding nature of the work and the need for specialized skills.

On the other hand, specialties like primary care or family practice may have lower on-call pay rates. It’s important for nurse practitioners to research the average on-call pay rates for their specific specialty to ensure they are being fairly compensated.

Geographic Differences

Geographic location is another factor that can affect nurse practitioner on-call pay rates. Wages can vary significantly from one state or region to another. For example, nurse practitioners working in urban areas or areas with a higher cost of living may earn more than those in rural areas.

It’s essential for nurse practitioners to consider the cost of living and the average wages for their specific location when negotiating their on-call pay rates.

It’s worth noting that the information provided here serves as a general guide, and actual on-call pay rates may vary. Nurse practitioners should consult reliable sources such as the American Association of Nurse Practitioners (AANP) or the Bureau of Labor Statistics for the most up-to-date information on average on-call pay rates in their area.

Factors That Determine On Call Pay for NPs

When it comes to on call pay rates for nurse practitioners (NPs), several factors come into play. Understanding these factors can help NPs negotiate fair compensation for their on-call duties. Here are some key factors that determine on call pay for NPs:

Your employer

The policies and practices of your employer play a significant role in determining your on-call pay rate as an NP. Different healthcare organizations may have varying compensation structures for on-call work.

It’s essential to familiarize yourself with your employer’s policies and discuss compensation expectations upfront.

Specialty and patient acuity

The specialty in which you practice as an NP can impact your on-call pay rate. Specialties with higher patient acuity levels or those that require round-the-clock availability may offer higher compensation for on-call work.

For example, NPs working in critical care or emergency medicine may receive higher pay rates compared to those in primary care.

Location and cost of living

The geographic location of your practice can influence your on-call pay rate. Areas with a higher cost of living and greater demand for NPs may offer higher compensation for on-call work. Additionally, regional variations in healthcare reimbursement rates can also impact your on-call pay.

Experience and qualifications

Your level of experience and qualifications as an NP can affect your on-call pay rate. NPs with more years of practice and advanced certifications may command higher compensation for their on-call services. It’s essential to highlight your expertise and credentials when negotiating on-call pay rates.

Reimbursement for expenses

Some employers may provide reimbursement for expenses incurred during on-call duties, such as mileage or accommodation costs. These reimbursements can add to the overall compensation package for on-call work.

It’s important to clarify whether such reimbursements are included or negotiable when discussing on-call pay.

Union contracts

If you are a member of a nurse practitioner union, your on-call pay rate may be determined by the collective bargaining agreement. Union contracts often outline specific compensation rates for on-call work, ensuring fair and consistent pay across the board.

Familiarize yourself with your union’s contract provisions related to on-call compensation.

By considering these factors and advocating for fair compensation, nurse practitioners can ensure that their on-call pay rates align with their skills, experience, and the demands of their specialty.

How On Call Pay Is Calculated

When it comes to nurse practitioner on call pay rates, there are several factors that come into play. Understanding how on call pay is calculated can help nurse practitioners make informed decisions about their compensation. Here are some key considerations:

Hourly pay vs stipend

One important factor in calculating on call pay is whether the nurse practitioner receives an hourly pay or a stipend. Some healthcare facilities offer a set amount of money for being on call, regardless of the actual number of hours worked. This is known as a stipend.

On the other hand, some facilities pay nurse practitioners an hourly rate for the time they spend on call. It’s important to clarify with your employer which method they use to calculate on call pay.

Minimum number of paid hours

Another aspect to consider is the minimum number of paid hours for being on call. Some employers have a minimum threshold, such as a minimum of two hours, before on call pay is triggered. This means that even if the nurse practitioner is only called for a short period of time, they will still be compensated for the minimum number of hours.

It’s essential to check the specific policies of your employer to understand how they calculate on call pay.

Portal-to-portal pay

Portal-to-portal pay refers to the compensation that nurse practitioners receive for the time spent traveling from their home to the healthcare facility and back during on call shifts. This can be an additional factor in calculating on call pay rates.

Some employers may offer portal-to-portal pay, while others may not. It’s important to inquire about this aspect of compensation during the negotiation process.

Overtime pay

In certain situations, nurse practitioners may be eligible for overtime pay when working on call shifts. Overtime pay is typically calculated as time and a half or double the regular hourly rate. However, it’s important to note that overtime pay eligibility may vary depending on local labor laws and the specific policies of the healthcare facility.

Be sure to familiarize yourself with the overtime pay regulations in your area to understand how it applies to on call shifts.

Negotiating Better On Call Pay as a Nurse Practitioner

When it comes to negotiating better on call pay as a nurse practitioner, there are several strategies you can employ to ensure you are fairly compensated for your time and expertise. By understanding the market rates, highlighting your skills and experience, and advocating for additional benefits, you can increase your earning potential and improve your work-life balance.

Here are some tips to help you negotiate better on call pay:

Know the market rates

Before entering into negotiations, it’s important to have a clear understanding of the market rates for on call pay in your area. Research local hospitals, clinics, and healthcare organizations to gather data on what other nurse practitioners are earning for their on call hours.

Websites like and can provide valuable insights into industry standards. Armed with this information, you can confidently discuss your compensation expectations with your employer.

Highlight your skills and experience

When negotiating on call pay, it’s important to showcase your skills and experience to demonstrate your value to the organization. Emphasize any specialized training, certifications, or advanced degrees you possess that set you apart from other nurse practitioners.

Highlighting your expertise in a particular area can justify a higher pay rate for your on call hours. Remember to be confident in your abilities and articulate how your skills benefit both patients and the healthcare organization.

Ask about pay tiers based on patient volume

Some healthcare organizations have pay tiers based on patient volume. This means that if you are responsible for a higher number of patients during your on call shift, you may be eligible for a higher pay rate.

Inquire about these pay tiers during negotiations to ensure you are being compensated fairly for the workload you will be undertaking. This can be an effective way to negotiate a higher on call pay rate.

Request higher stipends for holidays

On call shifts that fall on holidays can be particularly demanding and disruptive to your personal life. When negotiating your on call pay, consider requesting higher stipends for holidays. This acknowledges the sacrifice you are making by being available to work during special occasions.

By advocating for additional compensation for holiday on call shifts, you can improve your work-life balance and feel more appreciated for your commitment to patient care.

Negotiate minimum paid hours

One way to ensure you are fairly compensated for your on call time is to negotiate for a minimum number of paid hours. For example, you can request that if you are called in for a patient consultation, you are guaranteed a minimum of four hours of pay, regardless of the actual time spent providing care.

This can protect you from being called in for brief consultations that do not adequately compensate you for your time and expertise.

Get pay for expenses

It’s important to consider any expenses you may incur while on call, such as travel costs or additional childcare arrangements. When negotiating your on call pay, discuss the possibility of receiving reimbursement for these expenses.

By advocating for reimbursement, you can ensure that you are not shouldering the financial burden of being on call and can focus on providing quality care to your patients.

By using these strategies and advocating for yourself, you can negotiate better on call pay as a nurse practitioner. Remember to do your research, highlight your skills, and be open to discussing additional benefits that can improve your overall compensation package.

Negotiating fair on call pay is not only important for your financial well-being but also for maintaining a healthy work-life balance.

Other Considerations for NP On Call Work

Impact on work-life balance

Taking on call shifts as a nurse practitioner can have a significant impact on work-life balance. Being available to respond to emergencies or patient needs outside of regular working hours can disrupt personal plans and commitments. It may require sacrificing personal time or family events.

While on call, NPs need to be prepared to respond promptly and be available for the duration of their shift. This can be challenging and may lead to increased stress levels and feelings of burnout.

Potential for burnout

The potential for burnout is a real concern for nurse practitioners who frequently take on call shifts. The constant availability and the pressure to respond quickly to emergencies can lead to high levels of stress and emotional exhaustion.

It is essential for NPs to prioritize self-care and establish boundaries to prevent burnout. This may include setting aside time for relaxation, engaging in stress-reducing activities, and seeking support from colleagues and mentors.

Liability and malpractice insurance

When working on call, nurse practitioners should be aware of their liability and malpractice insurance coverage. It is crucial to ensure that they have adequate coverage for any potential issues or claims that may arise while providing care outside of regular working hours.

NPs should consult with their employer or insurance provider to understand the terms and conditions of their coverage.

Tax implications

Taking on call shifts can have tax implications for nurse practitioners. Depending on the specific circumstances and jurisdiction, the income earned from on call work may be subject to different tax regulations.

It is recommended that NPs consult with a tax professional or accountant to understand the tax implications and ensure compliance with relevant tax laws.

On call benefits to hospital/practice

While on call work can be demanding for nurse practitioners, it also provides benefits to the hospital or practice they are affiliated with. Having NPs available during off-hours ensures that patients receive timely and appropriate care, reducing the need for emergency room visits and improving overall patient satisfaction.

On call work also contributes to the efficient functioning of the healthcare system, allowing for better coordination and continuity of care.

Is taking call mandatory?

Whether taking call shifts is mandatory or optional for nurse practitioners can vary depending on the employer or practice setting. Some organizations may require NPs to participate in on call rotations as part of their job responsibilities, while others may offer it as a voluntary opportunity.

It is important for NPs to clarify the expectations and requirements with their employer before accepting a position or agreeing to take on call shifts.

Frequently Asked Questions About On Call Pay for NPs

How often do NPs take call?

Nurse practitioners (NPs) may be required to take call shifts depending on their practice settings and job responsibilities. The frequency of on-call shifts can vary greatly, ranging from once a week to once a month or even less frequently.

It ultimately depends on the specific needs and demands of the healthcare facility or organization.

Are there limits on hours spent on call?

While there are no specific federal regulations regarding the maximum number of hours an NP can spend on call, many healthcare facilities have implemented policies to ensure a reasonable balance between work and personal life.

It is important for NPs to discuss and negotiate their on-call schedules to prevent excessive workload or burnout.

What duties are expected when on call?

When on call, NPs are typically expected to be available to handle urgent patient needs and provide medical advice or guidance over the phone. They may need to triage and assess patients remotely, make decisions about appropriate treatments, and coordinate care with other healthcare professionals if necessary.

The specific duties may vary depending on the healthcare facility and the nature of the NP’s practice.

What if I’m not contacted during my call shift?

If an NP is not contacted during their on-call shift, it is important to remember that being on call is still considered work time. Even if no calls are received, the NP is expected to be available and ready to respond if needed.

It is advisable to document the hours spent on call, even if no patient interactions occur, to ensure accurate compensation and compliance with employment regulations.

Can I negotiate no call pay?

Whether or not an NP can negotiate for no call pay depends on the specific employment agreement, practice setting, and organizational policies. Some healthcare facilities may offer the option to opt-out of on-call duties in exchange for a reduction in pay.

It is important for NPs to have open and transparent discussions with their employers regarding their preferences and any possible alternatives.

Is call pay required by law?

There are no federal laws mandating call pay for NPs. However, state laws and regulations may vary. It is advisable to consult the labor laws specific to the state in which the NP practices. Additionally, collective bargaining agreements, employment contracts, and organizational policies can also influence whether or not call pay is required.


Being on call as a nurse practitioner requires professionalism and dedication. While it can disrupt your personal life, it provides critical services to patients in need. Understanding typical on call pay rates, how pay is determined, and negotiation strategies empowers you to maximize your compensation.

The key factors influencing on call pay are your employer, specialty, experience level, and geographic region. By researching rates and highlighting your skills, you can negotiate a fair rate. Just remember that being available on call showcases your commitment as a healthcare provider.

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