Allergy immunology NP salary: what to expect and how to earn more

Allergy and immunology nurse practitioners earn between $110,000 and $165,000 annually in most US markets, based on aggregate data from Nurse.org, ZipRecruiter, Glassdoor, and specialty compensation surveys. The Bureau of Labor Statistics does not publish an allergy/immunology-specific NP salary code – all NPs fall under SOC 29-1171 regardless of specialty. Specialty salary estimates therefore draw on survey data, job posting analysis, and wRVU productivity benchmarks. The BLS national median for all NPs was $132,300 per year as of May 2025, with a mean of $137,300.

Those two numbers are worth separating, because third-party salary content mixes them constantly. The median is the midpoint of the profession; the mean is pulled upward by the highest earners. A specialty figure compared against the wrong one will look like a premium or a discount that does not exist.

Allergy/immunology NPs sit close to the all-NP median rather than above it. The specialty’s procedural volume (allergy skin testing, immunotherapy administration) and biologic prescribing productivity push high-volume private-practice roles into the upper quartile, while salaried and academic positions land below the median. The field is not the highest-paying NP specialty, and its argument rests elsewhere: outpatient-only scheduling, Monday–Friday hours, long-term patient relationships, and unusually high clinical interest for a non-acute specialty.

For the full career pathway overview, see how to become an allergy immunology NP.

Quick-scan: allergy/immunology NP salary benchmarks

BLS baseline and specialty premium

The BLS May 2025 median for all NPs (SOC 29-1171) was $132,300 annually, or $63.61 per hour. The full percentile spread for the occupation runs $101,340 at the 10th percentile, $117,990 at the 25th, $156,700 at the 75th, and $174,420 at the 90th, across a workforce of roughly 323,040 NPs.

Set against that spread, allergy/immunology is a mid-band specialty whose top end is procedurally driven. A salaried allergy NP doing predominantly E&M work lands near or below the all-NP median. Two mechanisms move an individual toward the 75th percentile and above:

1. Procedural revenue – Allergy skin testing (CPT 95004, 95024) and immunotherapy (CPT 95165, 95144, plus 95115/95117 for the injection itself) generate billable revenue above standard E&M visits. Note that this revenue is overwhelmingly practice expense rather than physician work, so it lifts practice collections far more than it lifts an NP’s wRVU total – see the wRVU section below for why that distinction determines whether procedural volume reaches your paycheck.
2. Biologic prescribing – Dupilumab, omalizumab, mepolizumab, and other biologics generate high wRVU per encounter when managed by NPs. Biologic follow-up visits are coded at 99213/99214 level but often also involve prescription management, prior authorization, and patient education that adds to total productivity value.

NPs entering allergy from primary care without procedure experience tend to start below the BLS median. Those with immunotherapy training and biologic prescribing volume reach the 75th percentile within 3–5 years.

One caveat on all of the specialty figures in this guide: BLS OEWS is an establishment survey covering all NPs, while the allergy/immunology-specific numbers come from job-posting aggregates and employer surveys. The two instruments are not directly comparable, so treat the gap between them as directional rather than precise.

Salary by work setting

Setting is the biggest single variable in allergy/immunology NP compensation. The difference between a community health center and a high-volume private allergy practice can exceed $40,000 annually.

What moves the number: salary levers

Biologic prescribing volume

Dupilumab (Dupixent) is now one of the highest-revenue biologics in all of medicine. Allergy NPs who manage large dupilumab panels – severe atopic dermatitis, eosinophilic asthma, CRSwNP, EoE – generate substantial wRVU. Omalizumab (Xolair), which received FDA approval for IgE-mediated food allergy in 2024 alongside its existing allergic asthma/CIU indications, adds further prescribing volume. In productivity-based models, this directly increases earnings.

Immunotherapy procedure volume (SCIT)

Subcutaneous immunotherapy (SCIT) generates CPT codes that add to daily practice revenue:

• 95165 – Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, billed per dose
• 95144 – Professional services for antigens prepared as single-dose vials
• 95115 / 95117 – The injection itself, single or two or more

Bill these as component codes rather than reaching for 95120–95134. Those bundled “complete service” codes cover the injection and the antigen preparation together, and Medicare treats them as invalid – the component pairing is what gets paid.

NPs who supervise SCIT injection stations – even when the injections are administered by an MA under NP supervision – can bill for the professional services component. High-volume SCIT practices (50–100+ injection patients per week) produce meaningful revenue above E&M-only practices, though as the wRVU section below explains, that revenue is practice expense rather than provider work and reaches the NP only under collections-based or profit-sharing compensation.

Rush and cluster immunotherapy protocols

Some allergy practices run rush SCIT or cluster SCIT protocols that accelerate the buildup phase. These are time-intensive but productive: a single half-day rush protocol for one patient can generate multiple billable immunotherapy units. NPs credentialed in rush protocols add to practice revenue and are compensated accordingly.

Oral food challenge (OFC) credentialing

OFCs (CPT 95076, 95079) are 3–8 hour supervised graded food challenges. They require an NP or physician present throughout the procedure. In pediatric allergy practices, OFCs are a significant revenue line. NPs who can independently run OFCs are highly valuable and compensated above NPs who handle only E&M visits.

Full practice authority vs collaborative agreement states

NPs in full practice authority states can prescribe biologics, initiate immunotherapy, and bill under their own NPI without a physician co-signature requirement. In collaborative agreement states, the agreement may restrict prescribing scope or require physician chart co-signature, which limits productivity in some billing models. Moving to a full practice authority state is one of the most reliable ways to increase earning potential as an allergy/immunology NP.

Per the AANP State Practice Environment map (2026 edition), 27 states plus the District of Columbia grant full practice authority: Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, Wyoming, and Washington DC.

Twelve states operate under reduced practice authority (Wisconsin, Illinois, Indiana, Ohio, Pennsylvania, West Virginia, Arkansas, Mississippi, Alabama, Louisiana, New Jersey, and Kentucky), and eleven remain restricted: California, Missouri, Oklahoma, Texas, Michigan, Tennessee, Virginia, North Carolina, South Carolina, Georgia, and Florida.

Practice authority and pay do not track together, and the exception matters. California is a restricted-practice state and also the highest-paying NP market in the country. Several full-practice states sit in the bottom wage quartile. Guides that place an autonomy column beside a salary column without comment imply a correlation the data does not support. Autonomy is worth relocating for on its own terms – scope, billing independence, and the ability to run an independent panel – rather than as a proxy for a raise.

NHSC Loan Repayment: check eligibility before counting on it

Specialty salary guides routinely list NHSC Loan Repayment as a compensation lever for any NP working at a shortage-area site. For allergy/immunology that advice is usually wrong, and the error is expensive because it tells a reader to factor in a benefit they cannot claim.

The current NHSC Loan Repayment Program offers up to $75,000 for a full-time two-year service commitment and $37,500 half-time. Eligibility is discipline-gated: among nurse practitioners, the program covers family, adult, pediatric, women’s health, and psychiatric-mental health NPs delivering primary care or behavioral health at an NHSC-approved site. An allergy/immunology NP practicing in a specialty clinic does not qualify on the strength of the site alone.

Where the lever does apply is a genuine hybrid role. An NP employed by an FQHC to deliver primary care, whose scope includes allergy services as one component of a primary care panel, may qualify on the primary care work. The determining factor is the discipline and the care delivered, not the presence of a shortage-area designation. Confirm against the current fiscal-year application guidance before treating loan repayment as part of an offer.

The separate Nurse Corps Loan Repayment Program has its own rules – 60% of outstanding debt over two years with an optional third year at 25%, requiring service at a Critical Shortage Facility – and is frequently conflated with NHSC. Nurse Corps awards are not exempt from federal income and employment taxes.

On-call and anaphylaxis stipends

Hospital-based allergy NPs covering immunodeficiency infusion suites or allergy consult services may receive on-call pay or stipends for anaphylaxis readiness coverage. This varies by institution but can add $5,000–$15,000 annually at academic medical centers.

wRVU mechanics in outpatient allergy

Allergy/immunology is more procedure-heavy than most outpatient specialties, and the wRVU structure is where that fact stops behaving the way you would expect. The section below is worth reading before you sign a productivity-based contract, because the specialty’s procedures and its provider work sit in different columns of the fee schedule.

Common E&M codes:

• 99213 (established patient, moderate complexity) – 0.97 wRVU. Standard follow-up for allergic rhinitis, asthma maintenance.
• 99214 (established patient, moderate-high complexity) – 1.50 wRVU. Biologic follow-up, SCIT reaction assessment, complex asthma.
• 99203 (new patient, low-moderate complexity) – 1.60 wRVU
• 99204 (new patient, moderate complexity) – 2.60 wRVU. New allergy evaluation.

Allergy procedure codes. The important thing to understand here is that allergy procedures carry almost no physician work RVU. Their value sits in the practice expense component, which reimburses the antigen, the supplies, and the staff time rather than the provider’s effort. Guides that quote allergy procedure RVUs in the tenths are usually quoting the total non-facility RVU and calling it a work RVU, which overstates provider productivity by an order of magnitude.

• 95004 – Percutaneous (prick) allergy skin tests – 0.01 work RVU per test (total non-facility RVU roughly 0.12). Testing 40 aeroallergens generates about 0.4 wRVU from the testing itself; the E&M for interpretation is where the provider work is captured.
• 95024 – Intradermal skin tests – 0.01 work RVU per test (total non-facility RVU roughly 0.23).
• 95165 – Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, billed per dose – 0.06 work RVU per dose.
• 95115 / 95117 – Immunotherapy injection, single / two or more – 0.00 work RVU; these are practice-expense-only codes.
• 95076 / 95079 – Oral food challenge (initial 120 minutes / each additional 60 minutes) – 1.50 and 1.38 work RVU respectively. These are the only allergy procedures that carry substantial provider work, which is why OFC credentialing shows up repeatedly as a compensation lever.

A billing note that catches people out: CPT 95120–95134 are not valid for Medicare. Those are “complete service” codes bundling the injection with the antigen and its preparation, and Medicare requires the component codes (95115 or 95117 for the injection, plus 95144–95170 for the antigen) instead. A compensation model built on 95120 volume is built on a code most payers will not accept.

The practical consequence for an NP on a wRVU-based contract is that allergy procedure volume does far less for your productivity number than the specialty’s reputation suggests. A busy allergy NP running 4 new patient evaluations with skin testing plus 15 established patients a day generates roughly 25–30 wRVU from the E&M work, with the skin testing adding well under 1. The oral food challenges are the exception that moves the number. Where procedural volume genuinely pays is in practice revenue and collections-based models, which capture the practice expense component that wRVU models by definition exclude – so check which instrument your contract is measured on before assuming immunotherapy volume will carry your bonus.

Geographic salary table

Salaries vary significantly by state. The range below reflects what allergy/immunology NPs earn in each state’s competitive markets, based on aggregate job posting and survey data. High-ceiling markets are anchored by major academic allergy programs.

Specialty comparison

Allergy/immunology is one of several outpatient-dominant NP specialties with procedural components. Here is how it compares with adjacent specialties:

The dermatology comparison depends entirely on which dermatology you mean. Medical-only derm practice pays in a band comparable to allergy, and by some aggregates slightly below it. The dermatology earnings advantage is concentrated in cosmetic and Mohs surgical work, where the top tier runs well past anything available in allergy. Read that row as two different jobs sharing one specialty name rather than as a single higher-paying alternative. Rheumatology and pulmonology NPs earn in a band similar to allergy. Allergy/immunology’s differentiation is the OIT and biologic growth trajectory, which may widen the premium over the next decade.

For rheumatology salary data, see rheumatology NP salary. For dermatology salary data, see dermatology NP salary.

Career stage and experience

Salary progression in allergy/immunology follows a predictable arc. The biggest jump typically comes between years 1–3, when procedural competence (skin testing interpretation, SCIT supervision) becomes established and productivity metrics improve.

The pharma/biotech ceiling is real: Genentech, AstraZeneca, Sanofi, and GSK all hire allergy NPs as MSLs with total compensation (base + bonus + equity) well above clinical allergy NP salaries. However, MSL roles require demonstrated credibility in the specialty – typically 5+ years of clinical practice – and involve significant travel and relationship-building with KOLs.

Job outlook

The allergy/immunology NP workforce is growing faster than the allergist workforce. The specialty’s supply constraint is long-standing and documented: the ACAAI’s 2006 workforce white paper projected the allergist/immunologist supply falling from 3,660 to roughly 3,400 by 2020 while demand rose above 5,500, and fellowship applications have continued to decline as a share of the total (3.88% in 2007, 1.86% in 2015, 1.51% in 2022). Access is also geographically uneven, with allergist supply concentrated in metropolitan areas.

Note the vintage on those projections. Specialty societies re-run workforce studies infrequently, so a guide claiming a recent allergist workforce study is usually aging an older one forward. The food allergy epidemic has created patient demand that MD/DO allergists alone cannot meet, and OIT programs specifically require NP time (supervised build-up protocols, maintenance management, reaction response) that NPs perform as the primary APP.

BLS projects 40.1% NP employment growth from 2024 to 2034 across all NP specialties, against a 3.1% average for all occupations – roughly thirteen times the national rate, and the fastest projected growth of any occupation BLS tracks. Note that the Occupational Outlook Handbook publishes a separate 35% figure for the combined “nurse anesthetists, nurse midwives, and nurse practitioners” category; that is a broader grouping than SOC 29-1171 and the two are not interchangeable.

Allergy/immunology is likely to track above the all-NP average due to:

• The expanding biologic market (dupilumab approval for additional indications, omalizumab for food allergy, pipeline tezepelumab expansion)
• OIT program growth across academic and private settings
• Sustained food allergy prevalence and increasing awareness
• Inadequate supply of allergist-immunologist MDs to meet demand in non-metropolitan markets

Frequently asked questions

What is the average allergy immunology NP salary? Based on aggregate survey and job posting data, the median allergy/immunology NP salary is approximately $120,000–$130,000 annually. The BLS all-NP median (SOC 29-1171) was $132,300 in May 2025, so the specialty midpoint sits at or slightly below the all-NP median rather than above it. Allergy/immunology NPs in high-volume private practice with procedural competency can exceed $155,000, which clears the all-NP 75th percentile of $156,700 only at the top of that band.

Do allergy NPs earn more than primary care NPs? Modestly, in markets where procedural volume is high – driven by skin testing, immunotherapy, and biologic prescribing rather than by base salary. No federal dataset stratifies SOC 29-1171 by specialty, so any specific dollar premium you see quoted is an aggregator estimate rather than a measured figure. The mechanism is more reliable than the magnitude: procedure-heavy allergy practices using wRVU or collections-based compensation pay above E&M-only outpatient roles, and the gap widens with panel size.

Is productivity-based pay common in allergy practices? Yes. Private allergy practices frequently use wRVU-based or collections-based compensation models. This can work in the allergy NP’s favor given the procedural revenue (skin testing, SCIT) that allergy generates. Understand whether productivity bonuses apply to NP-billed services only or include incident-to billing under physician supervision – this distinction materially affects your earning potential.

Does getting a DNP increase allergy NP salary? Slightly and not consistently. Academic medical centers and health systems sometimes pay a $2,000–$8,000 base salary increment for a terminal degree. Private practices typically do not. The DNP does not change state prescribing scope in most states. If your goal is to maximize earnings in allergy, procedural skills and full practice authority state positioning matter more than the terminal degree.

For the full career pathway – education, certification, NP track selection, and fellowship options – see the companion allergy immunology NP career guide. For all-NP salary comparisons, see the nurse practitioner salary guide.

References

1. U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics: 29-1171 Nurse Practitioners,” May 2025 (released 2026). National median annual wage $132,300, mean $137,300; percentiles P10 $101,340, P25 $117,990, P75 $156,700, P90 $174,420; employment approximately 323,040.
2. U.S. Bureau of Labor Statistics, “Employment Projections, 2024–2034.” Nurse practitioners (SOC 29-1171) projected to grow 40.1%, against 3.1% for all occupations. Note the Occupational Outlook Handbook publishes 35% for the broader combined “Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners” category.
3. American College of Allergy, Asthma and Immunology, “Workforce White Paper,” 2006 (allergist/immunologist supply and demand projections to 2020); and Annals of Allergy, Asthma & Immunology, allergy/immunology physician workforce and fellowship application trend reporting.
4. American Association of Nurse Practitioners (AANP), “State Practice Environment,” 2026 edition (full, reduced, and restricted practice authority classification by jurisdiction).
5. American Medical Association, “CPT Professional” (allergy/immunology procedure codes 95004, 95024, 95076, 95079, 95115, 95117, 95144, 95165; E&M codes 99203–99204, 99213–99214).
6. Centers for Medicare & Medicaid Services, “Physician Fee Schedule Relative Value Files” (work RVU, practice expense RVU, and total RVU assignments by CPT code). Work RVUs cited above: 95004 and 95024 at 0.01, 95165 and 95144 at 0.06, 95115 and 95117 at 0.00, 95076 at 1.50, 95079 at 1.38. Practice expense, not work, carries the value of allergy procedures.
7. American Academy of Allergy, Asthma & Immunology, “RVU changes for allergy codes,” AAAAI advocacy resource – tabulates work RVUs, practice expense RVUs and total RVUs separately by allergy CPT code, and is the source for the work-versus-total distinction described above.
8. Centers for Medicare & Medicaid Services, “Billing and Coding: Allergy Immunotherapy,” Medicare Coverage Database Article A57472 – establishes that CPT 95120–95134 are not valid for Medicare and that component codes (95115, 95117, 95144–95170) must be used instead.
9. Health Resources and Services Administration (HRSA), “Fiscal Year 2026 National Health Service Corps Loan Repayment Program Application and Program Guidance” (up to $75,000 full-time / $37,500 half-time for a two-year commitment; eligible NP disciplines limited to family, adult, pediatric, women’s health, and psychiatric-mental health providing primary care or behavioral health at NHSC-approved sites). Nurse Corps Loan Repayment Program guidance for the separate Critical Shortage Facility pathway.
10. U.S. Food and Drug Administration, “FDA approves first medication to help reduce allergic reactions to multiple foods” (omalizumab/Xolair for IgE-mediated food allergy), February 2024.