Compensation6 min read36 views

Hospital Medicine PA Pay: Rounding, Admissions, and the Inpatient Premium

By VitalPost Editorial · October 10, 2026

Hospitalist PAs carry admissions, rounding, and cross-cover in a 24/7 specialty. The state PA baseline plus what inpatient scheduling adds to it.


Hospital medicine has quietly become one of the biggest employers of PAs: admitting overnight, rounding on team censuses, running cross-cover, and staffing observation units. The specialty inherited physician hospital medicine's scheduling DNA — seven-on/seven-off blocks, nights, and swing shifts — and with it, the differentials that push inpatient PA pay above clinic-based averages.

According to the U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) program (May 2025), physician assistants in the United States earn an annual mean wage of $141,280 and an annual median wage of $135,880. The median is the midpoint — half earn more, half earn less — and it is usually the safer "typical" reference because the mean gets pulled around by the highest earners.

An honest note on the data: BLS publishes PA wages by state for the profession as a whole — not by specialty. The table below is the profession-wide baseline from the May 2025 federal survey. Hospital medicine roles generally sit above that baseline for the reasons covered here, but for specialty-specific dollar figures, consult the professional-association surveys linked in the references; we don't invent numbers the federal data doesn't contain.

Rank State Annual mean wage
1 California $169,110
2 Washington $164,430
3 New Jersey $162,100
4 Oregon $155,300
5 New York $155,150
6 Vermont $152,520
7 New Hampshire $150,150
8 Alaska $148,080
9 Minnesota $147,630
10 Connecticut $146,930
11 Hawaii $146,780
12 Rhode Island $146,630
13 Massachusetts $146,480
14 District of Columbia $146,230
15 Indiana $144,260
16 Delaware $143,840
17 Virginia $142,630
18 Arizona $140,850
19 Montana $140,800
20 Iowa $139,870
21 Maryland $139,740
22 Colorado $139,580
23 Oklahoma $138,700
24 Missouri $137,710
25 Wyoming $137,320
26 Wisconsin $136,750
27 Ohio $136,560
28 Texas $135,850
29 Nevada $135,790
30 Maine $134,690
31 New Mexico $134,670
32 Florida $134,470
33 Nebraska $132,810
34 Idaho $132,540
35 Utah $132,530
36 Michigan $132,140
37 South Dakota $131,910
38 Illinois $131,880
39 North Dakota $130,930
40 Louisiana $130,290
41 North Carolina $130,030
42 West Virginia $128,830
43 Kansas $127,240
44 Pennsylvania $125,160
45 South Carolina $120,720
46 Kentucky $119,990
47 Arkansas $118,430
48 Tennessee $117,300
49 Georgia $112,090
50 Alabama $110,860
51 Mississippi $106,820

Figures are U.S. Bureau of Labor Statistics OEWS annual mean wages, May 2025 (51 states/territories with published data; BLS suppresses states with samples too small to publish, and those are omitted rather than estimated).

Why hospital medicine pays above the baseline

Schedule structure is the premium. Nocturnist PA roles, weekend blocks, and holiday coverage all carry differentials, and seven-on/seven-off patterns concentrate a full-time income into 26 working weeks. Autonomy varies widely by program — PAs running independent rounding lists with physician backup typically command more than dependent rounding models.

The baseline still matters. Specialty premiums ride on top of local market rates, so a hospital medicine PA in a high-baseline state generally out-earns the same role in a low-baseline one. Cost of living then reshapes the real value — compare any two states with our cost-of-living tool before treating a bigger number as a better offer.

See who's hiring. Browse open Physician Assistant roles on VitalPost — free for clinicians, and pay is shown on a listing whenever the employer posts it.

How to read these numbers

A few caveats keep this table useful instead of misleading.

Median first, mean second. The mean is sensitive to a small number of very high earners; the median is the midpoint and usually the better proxy for a typical offer. Read both to understand the spread in your market.

One number, many jobs. Each state figure blends employers, settings, and experience levels — a first-year attending and a 25-year veteran, a rural solo practice and a flagship academic center — into a single average. Expect your own market position to move you off the line.

The survey measures wages, not packages. Bonuses, productivity incentives, call stipends, benefits, retirement match, paid time off, and loan repayment sit outside OEWS. Evaluate offers on total value.

Self-employment is invisible here. Partnership income and 1099 arrangements are not fully captured, which is one reason real-world compensation in some markets runs above what a wage survey suggests. And because PA pay is frequently hourly or shift-based in this specialty, always reduce competing offers to an effective hourly rate — including differentials — before comparing.

References

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