The national salary range for palliative care nurse practitioners runs approximately $118,000–$150,000 per year, with a median near $128,000–$133,000 for hospital-based and outpatient palliative NPs. Hospice agency NPs in home-based roles tend to cluster in the $112,000–$135,000 range, with on-call stipends adding $1,500–$4,000 per month in many hospice organizations. The BLS does not separately track palliative care NP salaries – the BLS NP median (SOC 29-1171, May 2025 OEWS) of $132,300 covers all NP specialties – so specialty estimates draw on job board aggregates, hospice and palliative workforce survey data, and disclosed compensation from health system job postings.
Palliative care NPs earn modestly below the highest-paying procedural NP specialties (cardiology, anesthesia, dermatology), and land at or slightly above primary care NP earnings, particularly in academic medical center settings where hospital palliative care consultation teams are well-resourced. ACHPN certification is widely reported to carry a salary premium, though no peer-reviewed dataset quantifies it precisely. The most meaningful compensation variable after geography is work setting: academic medical center palliative consultation teams pay more than standalone hospice agencies, often 15–20% more for comparable experience levels.
For career pathway information, see the companion how to become a palliative care nurse practitioner guide.
National salary overview
| Metric | Value | Source / notes |
|---|---|---|
| BLS all-NP median (May 2025) | $132,300 | SOC 29-1171; all NP specialties combined |
| BLS all-NP 25th–75th percentile (May 2025) | $117,990–$156,700 | SOC 29-1171; the middle half of all NPs nationally |
| Palliative care NP national average | ~$128,000–$135,000 | Specialty aggregate from ZipRecruiter, Glassdoor, Salary.com; hospital-based settings weighted higher |
| Hospice NP national average | ~$112,000–$130,000 | Home-based hospice roles; excludes on-call stipends |
| Palliative care NP entry-level (0–2 years NP) | ~$101,000–$118,000 | Adjusted for setting and geography; brackets the BLS 10th percentile of $101,340 |
| Palliative care NP senior (10+ years) | ~$145,000–$174,000 | Lead NP, program director, or academic palliative care appointment; upper bound near the BLS 90th percentile of $174,420 |
| ACHPN certification premium | Reported but not quantified in published data | Employers commonly pay certification differentials, but no public dataset isolates the effect for palliative care NPs |
Methodology note: The BLS does not break out palliative care or hospice NP salaries separately. There is no palliative-care-specific federal occupation code – every palliative care NP is counted under SOC 29-1171 (Nurse Practitioners) alongside every other NP specialty, the same limitation that applies to oncology, cardiology, and other NP subspecialty wage estimates. The specialty figures above combine disclosed salary ranges from hospital system job postings and commercial aggregators (ZipRecruiter, Glassdoor, Salary.com) for “palliative care nurse practitioner” and “hospice nurse practitioner” search terms. Those aggregators rely on self-reported and posting-derived data with far smaller samples and weaker methodology than the OEWS survey. Use them as directional benchmarks calibrated to your geography, employer type, and experience level, and treat the BLS percentile distribution as the statistically reliable anchor.
Salary by work setting
Work setting is the single strongest predictor of palliative care NP compensation, controlling for geography and experience. Academic medical centers with formal palliative care consultation services pay the highest base salaries; standalone hospice agencies typically pay less base salary but compensate with on-call stipends and mileage reimbursement that partially close the gap.
| Setting | Typical salary range | Notes on compensation structure |
|---|---|---|
| Academic medical center – inpatient palliative care consultation | $130,000–$160,000 | Salaried; typically includes full benefits, retirement matching, CME allowance ($2,500–$5,000/yr); may include teaching and research responsibilities in faculty-adjacent roles |
| Community hospital – palliative care consultation team | $118,000–$145,000 | Salaried; benefits comparable to academic center; smaller palliative teams may carry broader scope per NP |
| Outpatient palliative care clinic (health system) | $122,000–$147,000 | Salaried or wRVU-based; no on-call in most outpatient programs; clinic hours (M–F) |
| Hospice agency – home-based | $108,000–$128,000 | Base salary plus on-call stipend ($1,500–$4,000/month); mileage reimbursement; caseload-based (12–18 patients typical); large agencies (VITAS, Compassus) offer 401(k) matching |
| Inpatient hospice unit (IPU) | $112,000–$135,000 | Shift-based or salaried; IPU NPs manage acute symptom crises; some weekend/night coverage required |
| Community-based palliative care program | $110,000–$130,000 | Home visit-based; mileage reimbursement essential; some programs use telehealth hybrid models that reduce driving burden |
| PACE program (palliative/geriatric hybrid) | $112,000–$132,000 | All-inclusive elder care program; NP carries geriatric panel with palliative care responsibilities; government-contracted, predictable funding |
Salary by state
The BLS reports NP salaries by state under SOC 29-1171 but does not break out palliative care specifically. State NP medians serve as the appropriate benchmark, adjusted for local cost of living and market demand. High-cost coastal states pay substantially more in absolute terms; the Pacific and mid-Atlantic states lead the national rankings.
The table below shows verified May 2025 OEWS state medians for all nurse practitioners. Palliative care NP pay in each state generally tracks a few percentage points either side of the state NP median, depending on whether the role sits in an academic health system or a community hospice agency.
| State | BLS NP annual median (May 2025) | Difference vs national NP median |
|---|---|---|
| California | $168,520 | +$36,220 |
| New Jersey | $159,310 | +$27,010 |
| Washington | $156,100 | +$23,800 |
| New York | $153,510 | +$21,210 |
| Massachusetts | $142,440 | +$10,140 |
| United States (all states) | $132,300 | – |
| Texas | $131,670 | –$630 |
| Florida | $129,510 | –$2,790 |
| Mississippi | $124,730 | –$7,570 |
Source: BLS Occupational Employment and Wage Statistics, SOC 29-1171 (Nurse Practitioners), May 2025 state estimates, accessed via ONET OnLine. Check your own state at the ONET local wages tool before making a relocation decision.
Note: California’s high NP median reflects both cost of living and the state’s practice environment, which supports broad NP employment across health systems. States with restricted practice laws and lower NP supply-demand ratios tend to cluster at the lower end. The spread between the highest and lowest state medians here is roughly $44,000, larger than the gap between most NP specialties.
ACHPN certification premium
ACHPN certification is administered by the Hospice and Palliative Credentialing Center (HPCC), a separately governed nonprofit certifying body that sits alongside the Hospice and Palliative Nurses Association under the Advancing Expert Care umbrella, and is accredited by the Accreditation Board for Specialty Nursing Certification. Eligibility requires an active APRN license, completion of an accredited graduate NP or CNS program, and either 500 hours of hospice and palliative nursing practice in the past year or 1,000 hours in the past two years.
Certification is widely reported to correlate with higher compensation, but no published dataset isolates the size of that effect for palliative care NPs specifically. Commercial aggregators do not reliably distinguish certified from uncertified postings, and the OEWS survey does not collect credential data at all. What can be stated with confidence is the mechanism rather than the magnitude: some employers pay explicit certification differentials as a line item in the compensation package, and certified NPs are more competitive for senior and lead positions that carry higher base pay. If you see a specific percentage premium quoted elsewhere, ask what dataset produced it.
Exam fees are set by HPCC and revised periodically, with a substantial discount for HPNA members. Published third-party figures vary, so confirm the current fee on the HPCC site before budgeting. Certification lasts four years. Renewal runs through the Hospice and Palliative Accrual for Recertification (HPAR) process, which requires maintaining practice hours and accumulating professional-activity points, plus a Situational Judgment Exercise. There is no straight re-examination requirement for NPs who meet the HPAR criteria.
HPNA membership additionally provides:
- Discounted exam and renewal fees
- Access to the Journal of Hospice and Palliative Nursing and other CE-eligible publications
- Annual conference with CE sessions that generate professional-activity points toward ACHPN renewal
- Practice guidelines and clinical tools
Maintaining HPNA membership through the 4-year certification cycle typically saves more in renewal fees than the membership costs, particularly for NPs renewing via CE.
Career progression and salary growth
Palliative care NP compensation increases predictably with years of experience and leadership responsibility. The typical progression:
Staff palliative care NP (0–3 years NP): $101,000–$122,000. Mentored practice on a palliative consultation team or hospice caseload. Primary focus is clinical skill development – opioid titration, dyspnea management, goals-of-care facilitation, interdisciplinary team integration.
Senior palliative care NP (4–9 years NP): $122,000–$143,000. Independent clinical management of complex cases. May serve as clinical resource for newer NPs. Eligible to precept NP students or supervise hospice NPs on agency caseloads.
Lead/advanced practice lead (8–12 years): $140,000–$160,000. Operational and clinical leadership for a palliative care service or hospice NP team. Typically involves quality improvement project leadership, staff education, and collaboration with palliative care physicians on program development.
Palliative care program director (10+ years): $155,000–$180,000. Administrative leadership of a hospital or health system palliative care program. Responsibilities extend into hiring, budget management, accreditation, and strategic planning. Often requires DNP or relevant leadership credential.
Faculty / academic palliative care NP (10+ years): $130,000–$165,000. Clinical faculty role at a school of nursing or medical school with palliative medicine program. Combines clinical practice, teaching, and research; total compensation varies widely with institutional funding and grant activity.
Palliative care NP vs. other NP specialty salaries
| Specialty | National average / range | Premium vs. all-NP BLS median | Key salary driver |
|---|---|---|---|
| Palliative care NP | $118,000–$150,000 | Below median to ~13% above | Setting (academic vs hospice), ACHPN certification, on-call stipends |
| Oncology NP | $142,000–$148,000 | ~7–12% above | Chemo certification differential, wRVU productivity, academic center premium |
| Cardiology NP | $142,000–$163,000 | ~7–23% above | Procedural subspecialty (EP lab, cath lab), per-case stipends |
| Geriatric NP (AGPCNP) | $116,000–$134,000 | Below to near median | Outpatient/SNF setting; less variation by employer type |
| Hospice NP (home-based) | $112,000–$132,000 | ~0–15% below median | On-call stipends partially offset lower base; large geographic variation |
| Family NP (FNP) – primary care | $124,000–$134,000 | Near median | Volume-based; RVU productivity in larger practices |
| Emergency NP (ENP-C) | $132,000–$157,000 | ~0–19% above | Shift differentials, locum tenens premium, evening/night pay |
Palliative care NPs earn near or slightly below the all-specialty NP median in purely base salary terms. The compensation picture changes when on-call stipends, CME allowances, loan repayment eligibility (many palliative and hospice roles sit at NHSC-approved sites in shortage areas), and the non-monetary aspects of the role are factored in. Many palliative care NPs have chosen the specialty specifically because the patient complexity and communication demands are a professional priority, not because it maximizes hourly earnings.
On-call and after-hours compensation
On-call is a significant compensation component in hospice settings that most salary benchmarks report incompletely. Hospice NPs – particularly in home-based roles – frequently carry on-call responsibilities for after-hours symptom management and family support. The compensation structure varies by employer:
Flat on-call stipend: Most common in hospice agencies. Monthly on-call stipends typically range from $1,500 to $4,000 per month, depending on frequency (one week per month vs rotating) and call volume. Large national hospice chains (VITAS, Compassus, Enclara Pharmacia-affiliated agencies) use structured stipend schedules published in job postings.
Hourly on-call rate: Less common but used by some community and PACE-affiliated programs. Rates typically run $15–$30/hour for being on-call, plus a separate call-back rate ($45–$75/hour) if the NP is activated for a patient visit or phone management episode.
No on-call: Inpatient hospital palliative care consultation teams and outpatient palliative clinics typically do not carry after-hours on-call responsibilities – nights and weekends are covered by the inpatient attending or an on-call physician. This is a meaningful lifestyle factor for NPs comparing hospital palliative roles to hospice agency roles.
When evaluating total compensation for a hospice NP role, add the annualized on-call stipend to the base salary before comparing to non-call positions. A hospice NP at $122,000 base with a $2,500/month on-call stipend has total cash compensation of approximately $152,000 – substantially above the stated base, and above the national NP median.
Loan repayment and financial incentives
Palliative care NPs may qualify for several loan repayment programs that are underutilized relative to other high-demand NP specialties:
NHSC Loan Repayment Program: The National Health Service Corps, administered by HRSA, offers loan repayment for nurse practitioners and other clinicians practicing at approved sites in Health Professional Shortage Areas (HPSAs). For fiscal year 2026, primary care NPs serving full-time on a two-year commitment can receive up to $75,000, with half-time awards up to $42,500. Behavioral health NPs serving in a mental health HPSA are eligible for up to $55,000 full-time. Awards are capped by the outstanding balance of qualifying educational loans, so the actual award may be lower than the maximum.
One caveat matters for palliative care specifically: NHSC eligibility attaches to the approved site and the service discipline, not to the palliative care specialty as such. A palliative care NP qualifies when the position sits at an NHSC-approved site and the role fits an eligible discipline. Hospice and community-based palliative roles in rural and low-income urban settings are the most likely to meet those criteria. Confirm site approval status with the employer before assuming eligibility.
State loan repayment programs: Many states administer their own APRN loan repayment funds, some of which specifically target hospice, palliative care, or end-of-life care providers. State health department workforce programs are the starting point for researching availability.
Employer tuition and loan assistance: Academic medical centers and large health systems increasingly offer student loan assistance as part of benefit packages. These are not limited to any specialty but are more commonly available in the hospital settings where palliative care consultation teams operate.
Internal resources
- How to become a palliative care nurse practitioner – full career pathway guide: ACHPN certification, education requirements, fellowship programs, scope of practice
- Nurse practitioner salary – all-specialty NP salary benchmarks by state and setting
- How to become a nurse practitioner – NP pathway overview for nurses at the start of the graduate education process
- Oncology NP salary – salary comparison for the closest overlapping specialty
- Palliative care nursing – clinical foundations of palliative nursing practice for context on the RN-level role
References
- U.S. Bureau of Labor Statistics. “Occupational Employment and Wage Statistics: Nurse Practitioners (SOC 29-1171),” May 2025 national and state estimates. National median annual wage $132,300; 10th percentile $101,340, 25th percentile $117,990, 75th percentile $156,700, 90th percentile $174,420. https://www.bls.gov/oes/current/oes291171.htm
- O*NET OnLine. “Summary Report for 29-1171.00 – Nurse Practitioners” and associated state local-wages tool, reporting BLS May 2025 OEWS wage data. Used for the state-level medians in this guide. https://www.onetonline.org/link/summary/29-1171.00
- U.S. Bureau of Labor Statistics. “Occupational Employment and Wage Statistics: Registered Nurses (SOC 29-1141),” May 2025. National median annual wage $97,550, cited for the RN-to-NP earnings comparison. https://www.bls.gov/oes/current/oes291141.htm
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook. “Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners,” 2024–2034 employment projections. Note that this combined APRN category is a different measurement from the NP-specific SOC 29-1171 series used above. https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
- Hospice and Palliative Credentialing Center (HPCC). “Advanced Certified Hospice and Palliative Nurse (ACHPN)” certification requirements, eligibility criteria, and current exam fees. Accredited by the Accreditation Board for Specialty Nursing Certification. https://www.advancingexpertcare.org/hpcc/
- Hospice and Palliative Credentialing Center (HPCC). “How to Recertify – ACHPN,” describing the four-year certification cycle, the Hospice and Palliative Accrual for Recertification (HPAR) process, and the Situational Judgment Exercise. https://www.advancingexpertcare.org/hpcc/recertification/how-to-recertify-achpn/
- Health Resources and Services Administration (HRSA), National Health Service Corps. “NHSC Loan Repayment Program,” Fiscal Year 2026 Application and Program Guidance. Award maxima of $75,000 (full-time, two-year primary care commitment) and $42,500 (half-time). https://nhsc.hrsa.gov/loan-repayment/nhsc-loan-repayment-program
- Hospice and Palliative Nurses Association (HPNA). Membership benefits, the Journal of Hospice and Palliative Nursing, and clinical practice resources referenced in the certification section. https://advancingexpertcare.org/