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 $128,490 per year as of May 2024.
Allergy/immunology NPs typically earn a modest premium over the all-NP median, driven by procedural volume (allergy skin testing, immunotherapy administration) and biologic prescribing productivity. The field is not the highest-paying NP specialty, but it offers strong workload quality: outpatient-only schedule, Monday–Friday hours, long-term patient relationships, and high clinical interest.
For the full career pathway overview, see how to become an allergy immunology NP.
Quick-scan: allergy/immunology NP salary benchmarks
| Percentile | Annual salary |
|---|---|
| 10th (entry-level, underserved market) | $98,000–$105,000 |
| 25th | $108,000–$115,000 |
| 50th (median) | $120,000–$130,000 |
| 75th | $138,000–$148,000 |
| 90th (high-volume private practice, full practice authority state) | $155,000–$165,000 |
BLS baseline and specialty premium
The BLS May 2024 median for all NPs (SOC 29-1171) was $128,490 annually, or $61.78 per hour. Allergy/immunology sits modestly above that median for two reasons:
- Procedural revenue – Allergy skin testing (CPT 95004, 95024) and immunotherapy (CPT 95165, 95120, 95144) generate billable revenue above standard E&M visits. NPs who perform and supervise these procedures add wRVU production that pure E&M practices do not generate.
- 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 at or below the BLS median. Those with immunotherapy training and biologic prescribing volume reach the 75th percentile within 3–5 years.
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.
| Work setting | Typical salary range | Notes |
|---|---|---|
| Private allergy practice | $120,000–$158,000 | Often productivity-based. High biologic and immunotherapy volume pushes toward upper end. |
| Academic medical center (allergy/immunology division) | $115,000–$145,000 | Base salary typically lower than private practice but total comp includes benefits, CME, research participation. |
| Pediatric hospital (allergy department) | $112,000–$142,000 | Pediatric hospitals typically pay below adult AMC; food allergy/OIT programs add procedural premium. |
| Integrated health system (allergy embedded in primary care) | $108,000–$135,000 | Salaried model, lower ceiling, better work-life integration; common in Kaiser, UPMC, Geisinger systems. |
| Community health center / FQHC | $95,000–$118,000 | Lowest ceiling but NHSC Loan Repayment Program eligibility — up to $50,000 tax-free per 2-year commitment. Effective compensation competitive for high-debt candidates. |
| Telehealth allergy | $110,000–$135,000 | Emerging model; suitable for SLIT monitoring and asthma follow-up. No skin testing or SCIT — lower procedural revenue ceiling. |
| Pharmaceutical / biotech (MSL or clinical educator role) | $140,000–$195,000+ | Genentech (Xolair), AstraZeneca (Fasenra/Tezspire), Sanofi/Regeneron (Dupixent), GSK (Nucala) all hire allergy-trained NPs as Medical Science Liaisons or clinical educators. Requires 5+ years specialty experience. Bonus and equity can materially increase total compensation. |
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 meaningfully add to daily revenue:
- 95165 – Professional services for allergy immunotherapy, >12 doses (per encounter with multiple vials)
- 95120 – Provision and injection of allergen immunotherapy, single injection
- 95144 – Professional services for antigens for allergen immunotherapy (per vial)
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 procedural revenue above E&M-only practices.
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 genuinely 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.
Current full practice authority states include: Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, and Wyoming (as of 2024–2025; verify current status).
NHSC Loan Repayment (FQHC allergy services)
Federal Qualified Health Centers offering allergy services in Health Professional Shortage Areas (HPSAs) qualify for NHSC Loan Repayment. The NHSC Loan Repayment Program offers up to $50,000 tax-free over a 2-year service commitment. For NPs with $100,000–$200,000+ in student debt, this is a meaningful effective compensation lever even at the FQHC salary ceiling.
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. Understanding the wRVU structure clarifies why high-volume allergy practices pay above the all-NP median.
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:
- 95004 – Percutaneous (prick) allergy skin tests – 0.17 wRVU per test. Testing 40 aeroallergens generates 6.8 wRVU from the testing alone, plus the E&M for interpretation.
- 95024 – Intradermal skin tests – 0.17 wRVU per test.
- 95165 – Professional services, allergy immunotherapy, >12 antigens – 0.50 wRVU per unit. A patient on 2 vials of SCIT generates 1.0 wRVU per visit.
- 95076 / 95079 – Oral food challenge (initial 120 min / each additional hour) – procedural revenue varies by institution.
A busy allergy NP running 4 new patient evaluations (with skin testing) + 15 established patients per day + supervising 30 SCIT injections can generate 35–50 wRVU per day. At a typical academic center rate of $45–$55 per wRVU, that is $1,575–$2,750 per day — well above what a pure E&M outpatient NP produces.
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.
| State | Estimated salary range | Notable allergy program(s) |
|---|---|---|
| Alabama | $105,000–$132,000 | UAB Allergy and Immunology |
| Arizona | $115,000–$148,000 | Mayo Clinic Arizona, Banner Health Allergy |
| California | $125,000–$162,000 | Stanford Allergy, UCSF Allergy, UCLA, Cedars-Sinai |
| Colorado | $118,000–$150,000 | National Jewish Health (world’s leading respiratory/allergy center) |
| Connecticut | $118,000–$148,000 | Yale Allergy and Immunology |
| Florida | $112,000–$145,000 | University of Florida Allergy, Miami Children’s, AdventHealth |
| Georgia | $110,000–$138,000 | Emory Allergy/Immunology, Children’s Healthcare Atlanta |
| Illinois | $115,000–$148,000 | Rush Allergy, Lurie Children’s, Northwestern Allergy |
| Indiana | $108,000–$135,000 | IU Health Allergy and Immunology |
| Iowa | $108,000–$132,000 | University of Iowa Allergy |
| Kansas | $105,000–$128,000 | KU Medical Center |
| Louisiana | $105,000–$130,000 | LSU Health Sciences Center |
| Maryland | $120,000–$155,000 | Johns Hopkins Allergy/Immunology, NIH Clinical Center |
| Massachusetts | $122,000–$160,000 | Mass General, Brigham and Women’s, Boston Children’s |
| Michigan | $112,000–$140,000 | University of Michigan Allergy, Henry Ford Health |
| Minnesota | $118,000–$150,000 | Mayo Clinic Rochester |
| Missouri | $108,000–$135,000 | Washington University, Children’s Mercy |
| Nebraska | $105,000–$130,000 | UNMC Allergy |
| New Jersey | $118,000–$150,000 | Hackensack Meridian, RWJBarnabas |
| New Mexico | $108,000–$135,000 | UNM Allergy; NHSC HPSA areas relevant |
| New York | $118,000–$158,000 | NYU Langone, Columbia, Weill Cornell, Northwell |
| North Carolina | $112,000–$142,000 | Duke Allergy, UNC Allergy |
| Ohio | $110,000–$140,000 | Cleveland Clinic Allergy, Ohio State Wexner, Cincinnati Children’s |
| Oregon | $118,000–$148,000 | OHSU Allergy; full practice authority |
| Pennsylvania | $112,000–$145,000 | Penn Allergy, CHOP Allergy, UPMC |
| Tennessee | $108,000–$135,000 | Vanderbilt Allergy, Le Bonheur Children’s |
| Texas | $112,000–$145,000 | UT Southwestern, Houston Methodist, TCH Allergy |
| Virginia | $115,000–$145,000 | UVA Allergy, VCU Health |
| Washington | $120,000–$152,000 | UW Medicine Allergy; full practice authority |
| Wisconsin | $112,000–$140,000 | UW Health Allergy, Children’s Wisconsin |
Specialty comparison
Allergy/immunology is one of several outpatient-dominant NP specialties with procedural components. Here is how it compares with adjacent specialties:
| Specialty | Typical NP salary range | Schedule | Procedural volume | Comparable? |
|---|---|---|---|---|
| Allergy/immunology NP | $110,000–$165,000 | M–F outpatient | High (skin testing, SCIT, OFC) | — |
| Dermatology NP | $115,000–$175,000 | M–F outpatient | High (biopsies, excisions, cosmetic) | Close – similar patient mix for atopic disease |
| Rheumatology NP | $112,000–$155,000 | M–F outpatient | Moderate (infusions, joint injections) | Close – shared autoimmune disease territory |
| Pulmonology NP | $115,000–$160,000 | Mixed outpatient/inpatient | Moderate (PFTs, bronchoscopy assist) | Close – overlapping asthma patient population |
| Endocrinology NP | $108,000–$148,000 | M–F outpatient | Low (predominantly E&M) | Moderate – similar outpatient lifestyle |
| ENT / otolaryngology NP | $110,000–$152,000 | M–F outpatient | Moderate (nasal scopes, minor procedures) | Moderate – CRS and rhinitis overlap |
| Gastroenterology NP | $115,000–$162,000 | Mixed | High (endoscopy assist) | Lower – different organ system |
Dermatology NPs tend to earn slightly more than allergy NPs in comparable markets because dermatology has more cosmetic revenue and a broader procedure set. Rheumatology and pulmonology NPs earn in a similar band. 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.
| Career stage | Years of experience | Typical salary |
|---|---|---|
| Entry-level | 0–2 years | $98,000–$115,000 |
| Mid-career | 3–6 years | $118,000–$138,000 |
| Experienced | 7–12 years | $135,000–$152,000 |
| Senior / high-volume or pharma | 12+ years | $148,000–$195,000+ |
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. AAAAI workforce surveys document persistent allergist shortages — particularly outside major metropolitan areas. 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% NP employment growth through 2033 for all NP specialties. Allergy/immunology is likely to track above that 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 $128,490 in May 2024. Allergy/immunology NPs in high-volume private practice with procedural competency and full practice authority can exceed $155,000.
Do allergy NPs earn more than primary care NPs? In most markets, modestly — perhaps $5,000–$15,000 above median primary care NP salary — driven by procedural volume and biologic prescribing. The premium is not as large as procedurally intensive specialties like dermatology or orthopedics.
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.