The median annual salary for an adult-gerontology nurse practitioner (AGNP) is approximately $119,000–$128,000, based on AANP Compensation Survey specialty data and BLS Occupational Employment and Wage Statistics (SOC 29-1171, May 2025). The all-NP national median is $132,300 – AGNPs typically land below that benchmark in primary care settings and closer to it in acute care. Most AGNPs earn between $105,000 and $145,000, with the highest salaries concentrated in California, New Jersey, New York, and Oregon.
Here is how those numbers break down by state, setting, and career stage.
| Metric | Value | Source |
|---|---|---|
| NP national median (all specialties) | $132,300 | BLS OEWS, May 2025 |
| NP national mean (all specialties) | $137,300 | BLS OEWS, May 2025 |
| AGNP primary care estimated median | ~$119,000 | AANP Compensation Survey |
| AGNP acute care estimated median | ~$125,000 | AANP Compensation Survey |
| AGNP 25th percentile | ~$99,000 | NPHub / aggregated survey data |
| AGNP 75th percentile | ~$126,000 | NPHub / aggregated survey data |
| AGNP entry-level (new grad) | ~$89,500–$95,000 | NPHub / PayScale 2025 |
| AGNP top earners (senior, high-cost state) | $145,000–$165,000+ | AANP / Nurse.org |
National AGNP salary overview
The BLS reports salary data for all nurse practitioners under a single occupational code (SOC 29-1171) – it does not break out AGNPs as a separate subcategory. The national NP median is $132,300 and the mean is $137,300 (BLS OEWS, May 2025). AGNP-specific data comes from the AANP annual compensation survey, which consistently shows primary care AGNPs earning around $119,000 and acute care AGNPs around $125,000.
AGNPs tend to earn less than the all-NP median for a straightforward reason: a significant portion of AGNPs practice in primary care, outpatient clinics, and long-term care facilities, which pay less than the hospital-based acute care and procedural settings that pull the all-specialty mean upward. Acute care AGNPs – those working in hospital medicine, ICU step-down, and hospitalist-support roles – close most of that gap, and experienced acute care AGNPs in high-cost markets can clear the all-NP median, though the specialty midpoint sits below it.
For all NPs, the BLS 10th–90th percentile spread runs $101,340 to $174,420 (May 2025). Applying the AGNP specialty discount, a realistic 10th–90th range for AGNPs is roughly $95,000 to $165,000. That spread of around $70,000 reflects geographic variation, employer type, practice authority, and subspecialty.
AGNP salary by state
The table below uses BLS OEWS May 2025 state-level data for all nurse practitioners (SOC 29-1171). Because BLS does not report AGNP-specific state figures, these represent the NP baseline from which AGNP salaries are derived – adjust approximately $5,000–$10,000 downward for primary care AGNP roles and $0–$5,000 upward for acute care AGNP roles in each state.
| State | NP annual median (BLS, May 2025) | AGNP primary care est. | Data basis |
|---|---|---|---|
| Alabama | $105,750 | ~$96,000–$102,000 | BLS OEWS confirmed |
| Alaska | $155,170 | ~$145,000–$151,000 | BLS OEWS confirmed |
| Arizona | $134,420 | ~$124,000–$130,000 | BLS OEWS confirmed |
| Arkansas | $125,660 | ~$116,000–$122,000 | BLS OEWS confirmed |
| California | $168,520 | ~$159,000–$165,000 | BLS OEWS confirmed |
| Colorado | $132,930 | ~$123,000–$129,000 | BLS OEWS confirmed |
| Connecticut | $138,470 | ~$128,000–$134,000 | BLS OEWS confirmed |
| Delaware | $131,040 | ~$121,000–$127,000 | BLS OEWS confirmed |
| District of Columbia | $135,880 | ~$126,000–$132,000 | BLS OEWS confirmed |
| Florida | $129,510 | ~$120,000–$126,000 | BLS OEWS confirmed |
| Georgia | $129,430 | ~$119,000–$125,000 | BLS OEWS confirmed |
| Hawaii | $135,570 | ~$126,000–$132,000 | BLS OEWS confirmed |
| Idaho | $132,540 | ~$123,000–$129,000 | BLS OEWS confirmed |
| Illinois | $130,680 | ~$121,000–$127,000 | BLS OEWS confirmed |
| Indiana | $128,830 | ~$119,000–$125,000 | BLS OEWS confirmed |
| Iowa | $130,160 | ~$120,000–$126,000 | BLS OEWS confirmed |
| Kansas | $126,650 | ~$117,000–$123,000 | BLS OEWS confirmed |
| Kentucky | $122,870 | ~$113,000–$119,000 | BLS OEWS confirmed |
| Louisiana | $125,600 | ~$116,000–$122,000 | BLS OEWS confirmed |
| Maine | $130,260 | ~$120,000–$126,000 | BLS OEWS confirmed |
| Maryland | $131,110 | ~$121,000–$127,000 | BLS OEWS confirmed |
| Massachusetts | $142,440 | ~$132,000–$138,000 | BLS OEWS confirmed |
| Michigan | $131,450 | ~$121,000–$127,000 | BLS OEWS confirmed |
| Minnesota | $133,260 | ~$123,000–$129,000 | BLS OEWS confirmed |
| Mississippi | $124,730 | ~$115,000–$121,000 | BLS OEWS confirmed |
| Missouri | $129,930 | ~$120,000–$126,000 | BLS OEWS confirmed |
| Montana | $137,210 | ~$127,000–$133,000 | BLS OEWS confirmed |
| Nebraska | $132,130 | ~$122,000–$128,000 | BLS OEWS confirmed |
| Nevada | $140,670 | ~$131,000–$137,000 | BLS OEWS confirmed |
| New Hampshire | $137,550 | ~$128,000–$134,000 | BLS OEWS confirmed |
| New Jersey | $159,310 | ~$149,000–$155,000 | BLS OEWS confirmed |
| New Mexico | $137,520 | ~$128,000–$134,000 | BLS OEWS confirmed |
| New York | $153,510 | ~$144,000–$150,000 | BLS OEWS confirmed |
| North Carolina | $128,990 | ~$119,000–$125,000 | BLS OEWS confirmed |
| North Dakota | $130,070 | ~$120,000–$126,000 | BLS OEWS confirmed |
| Ohio | $124,870 | ~$115,000–$121,000 | BLS OEWS confirmed |
| Oklahoma | $133,390 | ~$123,000–$129,000 | BLS OEWS confirmed |
| Oregon | $155,680 | ~$146,000–$152,000 | BLS OEWS confirmed |
| Pennsylvania | $130,140 | ~$120,000–$126,000 | BLS OEWS confirmed |
| Rhode Island | $135,970 | ~$126,000–$132,000 | BLS OEWS confirmed |
| South Carolina | $123,290 | ~$113,000–$119,000 | BLS OEWS confirmed |
| South Dakota | $128,840 | ~$119,000–$125,000 | BLS OEWS confirmed |
| Tennessee | $117,590 | ~$108,000–$114,000 | BLS OEWS confirmed |
| Texas | $131,670 | ~$122,000–$128,000 | BLS OEWS confirmed |
| Utah | $130,920 | ~$121,000–$127,000 | BLS OEWS confirmed |
| Vermont | $134,740 | ~$125,000–$131,000 | BLS OEWS confirmed |
| Virginia | $127,810 | ~$118,000–$124,000 | BLS OEWS confirmed |
| Washington | $156,100 | ~$146,000–$152,000 | BLS OEWS confirmed |
| West Virginia | $127,320 | ~$117,000–$123,000 | BLS OEWS confirmed |
| Wisconsin | $131,980 | ~$122,000–$128,000 | BLS OEWS confirmed |
| Wyoming | $132,200 | ~$122,000–$128,000 | BLS OEWS confirmed |
Notes on state data: BLS OEWS state figures are for all NPs (SOC 29-1171, May 2025). AGNP primary care estimates apply an approximate $7,000–$10,000 specialty discount based on AANP survey data. Acute care AGNPs in the same state typically earn 5–8% more than the primary care estimate shown.
The highest-paying states cluster along the coasts and in the Mountain West. California stands alone at the top at $168,520 for all NPs, with New Jersey second at $159,310 – a reshuffle from the prior data vintage, in which New Jersey sat well outside the leading group. Alabama is the lowest-paying state for NPs at $105,750, which translates to an AGNP primary care range that can dip below $100,000. Tennessee, at $117,590, is the lowest-paying of the large states.
AGNP salary by work setting
Setting is one of the largest single variables in AGNP compensation. Acute care hospital roles pay materially more than outpatient primary care or long-term care positions, though non-monetary factors – schedule, call burden, patient acuity – can offset the wage gap in either direction.
| Work setting | Estimated AGNP annual salary range | Notes |
|---|---|---|
| Inpatient hospital (acute care AGNP) | $130,000–$165,000 | Highest base pay; shift differentials and call add further |
| Hospitalist / hospital medicine group | $125,000–$155,000 | Often includes productivity bonus; 7-on/7-off common |
| Outpatient primary care clinic | $110,000–$130,000 | Most common AGNP setting; hours more predictable |
| Long-term care / skilled nursing facility (SNF) | $105,000–$125,000 | High demand, lower base; loan repayment often available |
| Home health / house calls | $110,000–$130,000 | Per-visit models vary; full-time salaried roles increasing |
| Telehealth (chronic care, geriatric management) | $115,000–$145,000 | Strong growth area; scope depends on state practice law |
| VA / federal government | $118,000–$148,000 | GS pay scale plus locality pay; strong benefits package |
| Academic medical center | $115,000–$135,000 | May include teaching release time; below private-practice peak |
| Community health center (FQHC) | $105,000–$120,000 | Eligible for NHSC loan repayment up to $75,000 over 2 years |
| Palliative care / hospice | $110,000–$135,000 | Growing subspecialty; AGNP background well-matched |
Acute care hospital roles dominate on raw salary, while telehealth and VA roles close the gap when total compensation is factored in. FQHCs and SNFs consistently offer the lowest base pay, and access to National Health Service Corps (NHSC) loan repayment of up to $75,000 for a two-year full-time commitment makes them worth considering for AGNPs carrying graduate school debt.
One eligibility caveat matters a great deal for this specialty. NHSC loan repayment is gated to primary care and behavioral health: adult-gerontology primary care NPs working at an NHSC-approved site in a designated Health Professional Shortage Area qualify, and AGACNP-BC holders in hospitalist, ICU, or other acute care roles generally do not. If loan repayment is central to your compensation math, confirm both the site’s NHSC approval status and that your role is classed as primary care before counting the award.
AGNP salary by experience level
Salary growth across an AGNP career follows a predictable arc: rapid in the first five years, steady from year five to fifteen, then plateau-dependent on advancement into leadership or specialty subspecialties.
| Career stage | Years of NP experience | Estimated salary range | Key drivers |
|---|---|---|---|
| New graduate | <1 year | $89,500–$100,000 | Employer type; full vs restricted practice state |
| Early career | 1–3 years | $100,000–$115,000 | Panel growth, prescribing confidence, employer loyalty premium |
| Mid-career | 3–7 years | $115,000–$130,000 | Productivity bonuses, specialty subspecialization |
| Experienced | 7–12 years | $125,000–$145,000 | Geographic leverage, acute care transition, DNP completion |
| Senior / advanced | 12+ years | $135,000–$165,000+ | Leadership roles, independent practice, high-cost-of-living markets |
New graduates in restrictive practice states – where a collaborative practice agreement with a supervising physician is required – tend to land toward the lower end of the new-grad range, because the administrative overhead of collaboration agreements makes some employers cautious about hiring costs. Full-practice-authority states (New York, Oregon, Washington, Arizona, and others) remove that friction and typically show higher starting offers. California, despite topping the wage table, is a restricted-practice state and does require a collaborative arrangement.
AGNP vs other NP specialties
AGNPs sit in the middle of the NP specialty salary distribution – above several primary care specialties on a per-hour basis in acute care settings, but below the highest earners in anesthesia and psychiatry.
| NP specialty | Estimated median salary | Primary certification | Typical setting |
|---|---|---|---|
| CRNA (certified registered nurse anesthetist) | $236,590 | NBCRNA (DNAP/MSN) | OR, ASC, hospital |
| Neonatal NP (NNP) | ~$135,000–$148,000 | NCC | NICU |
| PMHNP (psychiatric-mental health NP) | ~$132,000–$140,000 | ANCC PMHNP-BC | Outpatient, telepsychiatry |
| AGNP – acute care (AGACNP-BC) | ~$125,000–$135,000 | ANCC / AACN | Hospital, hospitalist |
| AGNP – primary care (AGPCNP-BC) | ~$119,000–$128,000 | ANCC / AANPCB | Outpatient, SNF, home health |
| FNP (family nurse practitioner) | ~$120,000–$130,000 | ANCC FNP-BC / AANPCB FNP-C | Primary care, urgent care |
| CNM (certified nurse midwife) | ~$120,000–$130,000 | AMCB | OB/GYN, birth center |
| Pediatric NP (PNP-BC) | ~$110,000–$125,000 | PNCB / ANCC | Pediatric primary care, hospital |
The gap between acute care and primary care AGNP roles is meaningful – roughly $6,000–$10,000 per year at the median. That gap compresses in high-cost states (California, New York) where primary care salaries are pulled up by cost-of-living pressure, and widens in lower-cost states where hospital positions attract larger premiums.
What affects AGNP pay
Certification track: AGPCNP-BC vs AGACNP-BC
The ANCC offers two separate adult-gerontology certifications. The AGPCNP-BC (Adult-Gerontology Primary Care NP Board Certified) is for outpatient and community practice. The AGACNP-BC (Adult-Gerontology Acute Care NP Board Certified) is for hospital and critical care settings. The AANPCB offers a parallel primary care credential, the AGNP-C, which is clinically equivalent to the ANCC AGPCNP-BC for most employers.
Acute care certification (AGACNP-BC) commands a salary premium because hospital-based roles typically pay more and because fewer programs offer the acute care track – supply is tighter. If your goal is maximum earning potential, the AGACNP-BC path is the higher-leverage choice.
State practice authority
Full practice authority states allow AGNPs to assess, diagnose, and prescribe without a physician collaboration agreement. As of April 2026, AANP classes 27 states plus the District of Columbia as full practice, 12 states as reduced practice, and 11 states as restricted practice. The distinctions matter for new graduates: states with full practice authority tend to have higher NP employment rates because AGNPs can open independent practices or command premium placement fees from multi-specialty groups.
Practice authority and pay do not track each other, though guides that place the two side by side often imply they do. California is a restricted practice state under the AANP classification and is also the highest-paying NP market in the country at a $168,520 median. Several full-practice states sit in the bottom quartile of the wage table. Weigh the working conditions you want and the wage you want separately, because one does not predict the other.
Employer type
Private equity-backed medical groups and large hospital systems typically offer higher base salaries than solo physician practices, FQHCs, or public health departments. However, productivity bonuses, ownership stakes, and loan repayment can invert that hierarchy. A primary care AGNP at a community health center earning $112,000, with a $75,000 NHSC award spread across a two-year commitment, is effectively earning around $149,500 a year over that period.
Subspecialty additions
AGNPs who add training in palliative care, wound care certification (WCC), or diabetes management can bill for additional services and often command a salary adjustment at contract renewal. Palliative care is a particular growth area – demand far outstrips supply and dedicated palliative-care NP positions frequently carry salary premiums of $10,000–$20,000 over general internal medicine NP roles.
Doctoral degree premium
A DNP does not guarantee a salary bump, but it helps at the negotiating table – particularly for hospital-employed positions and academic medical centers, where administrator-to-NP salary differentials are smaller when a doctoral credential is on the table. The premium varies: research suggests a $5,000–$15,000 advantage for DNP-prepared NPs in institutional settings.
Job outlook and demand
The BLS projects employment of nurse practitioners will grow 40.1% from 2024 to 2034, making it the fastest-growing occupation in the country and roughly 13 times the 3.1% projected for all occupations combined. For AGNPs specifically, the outlook is even more pointed: the AAMC estimates a shortage of over 30,000 geriatricians by 2030, and AGNPs are the primary workforce solution that health systems are reaching for to fill that gap.
The numbers behind the demand are structural rather than cyclical. The U.S. population aged 65 and older reached 61.2 million in 2024, per Census Bureau Vintage 2024 estimates, and is projected to reach 80 million by 2040. That cohort drives disproportionately high healthcare utilization: older adults account for roughly 35% of all hospital stays and 42% of all days of care. Chronic condition management – diabetes, COPD, heart failure, dementia – is the core of AGNP practice, and those conditions are growing in absolute prevalence with every passing year.
Rural areas face the most acute shortage. Many rural counties have no geriatrician within 60 miles, and AGNPs practicing with full independence are filling gaps that would otherwise go unfilled. Rural Health Information Hub data suggests rural AGNPs in primary care can leverage this shortage into above-median salaries and loan repayment packages that urban peers rarely see.
How to maximize your AGNP salary
Choose your setting strategically. Hospital-based acute care roles pay the most, but telehealth chronic care management is closing the gap quickly – without the shift-work burden. If work-life balance matters to you, a telehealth chronic disease management role can hit $130,000–$145,000 with a predictable schedule.
Target full-practice-authority states. Independent practice unlocks the ability to open your own panel or contract directly with Medicare – both routes to income above the employer-set salary ceiling. New York, Oregon, and Washington combine full practice authority with top-quartile NP wages. California pays the most of any state but is restricted-practice, so the independent-practice route is closed there.
Negotiate productivity bonuses. Many AGNP contracts structure base salary conservatively and attach a per-visit or panel-size bonus. Understand the RVU or panel math before you sign. A $115,000 base with a well-structured productivity bonus can clear $135,000 in year two.
Consider the NHSC for debt elimination. If you carry graduate school debt and work in primary care, two years at an NHSC-approved site can retire up to $75,000 tax-free – roughly the equivalent of $100,000 in additional gross pay across those two years at a typical effective tax rate. That changes the calculus on “lower-paying” FQHC and SNF roles substantially. Note the primary care restriction: acute care AGNPs in hospital roles are generally outside the eligible discipline list.
Complete your DNP if you’re targeting leadership. The doctoral premium is not universal, but it is consistent in hospital systems, academic medical centers, and VA settings. If those environments are your long-term target, the DNP return-on-investment math usually works.
Frequently asked questions
Is AGNP in high demand? Yes. The combination of an aging U.S. population and a persistent geriatrician shortage makes AGNPs one of the most in-demand NP specialties entering the 2030s. The AAMC projects a geriatrician shortage exceeding 30,000 by 2030. AGNPs – both primary and acute care – are the main pipeline for filling that gap, and health systems are actively competing for them.
How does AGNP salary compare to FNP salary? Primary care AGNPs and FNPs earn similar salaries – typically within $5,000–$10,000 of each other at the median. The bigger differentiator is setting: acute care AGNPs (AGACNP-BC) earn meaningfully more than FNPs because hospital-based positions carry higher base pay. An FNP in urgent care and an AGPCNP-BC in outpatient internal medicine will often land within the same band. See the FNP salary guide for a direct comparison.
How long does it take to become an AGNP? The AGPCNP-BC and AGACNP-BC credentials require completion of an accredited graduate program (MSN or DNP with an adult-gerontology focus) plus 500 hours of supervised clinical experience. Most MSN programs take 2–3 years post-BSN; DNP programs take 3–4 years. If you are already an RN, plan for 5–7 years total from BSN entry to first AGNP role. See the full NP pathway guide for step-by-step details.
Salary data sourced from BLS Occupational Employment and Wage Statistics (SOC 29-1171, May 2025), AANP NP Compensation Survey, and ANCC certification program data. AGNP-specific estimates apply specialty adjustments from AANP survey data to BLS state figures. Individual salaries vary by employer, negotiated contract terms, and geographic cost of living.
Related guides: PMHNP salary – CRNA salary – How to become a nurse practitioner – How to become a PMHNP
References
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics: Nurse Practitioners (29-1171) – National and State Estimates,” BLS OEWS, May 2025.
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics: Nurse Anesthetists (29-1151),” BLS OEWS, May 2025.
- U.S. Bureau of Labor Statistics, “Industry and Occupational Employment Projections Overview and Highlights, 2024–34,” Monthly Labor Review, 2026.
- U.S. Bureau of Labor Statistics, “Occupational Outlook Handbook: Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners – Job Outlook,” BLS, 2026.
- American Association of Nurse Practitioners, “AANP National Nurse Practitioner Compensation Survey,” AANP.
- American Nurses Credentialing Center, “Adult-Gerontology Primary Care (AGPCNP-BC) and Acute Care (AGACNP-BC) Certifications,” ANCC.
- Association of American Medical Colleges, “The Complexities of Physician Supply and Demand: Projections – Geriatrician Shortage,” AAMC.
- Health Resources and Services Administration, “Fiscal Year 2026 National Health Service Corps Loan Repayment Program Application and Program Guidance,” HRSA, 2026.
- U.S. Census Bureau, “Older Adults Outnumber Children in 11 States and Nearly Half of U.S. Counties – Vintage 2024 Population Estimates,” U.S. Census Bureau, June 2025.
- American Association of Nurse Practitioners, “State Practice Environment: Full, Reduced, and Restricted Practice Authority,” AANP, April 2026.