The pay gap between nurse practitioners and physician assistants in medical specialties fell from more than $7,000 to under $400 in 2025. That finding comes from AMGA's 2026 Medical Group Compensation and Productivity Survey, which pulled compensation and productivity data from 451 medical groups and nearly 188,000 providers across more than 190 specialties.
The survey, published June 26, 2026, tracks what medical groups actually paid physicians and advanced practice clinicians (APCs) in 2025, not what job postings advertise. For a practice that still budgets NP and PA pay as two different numbers, the shrinking gap changes the math behind a staffing plan built around advanced practice providers (APPs).
A gap that used to run in the thousands
AMGA's survey has tracked NP and PA compensation separately for years, and the two roles have historically paid differently even inside the same specialty group. In prior survey years, NPs in medical specialties earned more than $7,000 less than PAs in the same specialty category, according to AMGA. In the 2025 data, that gap narrowed to under $400, a shift AMGA's analysts flagged as one of the survey's most notable year-over-year changes.
Advanced practice clinician compensation overall grew 4.1% in 2025, AMGA found, just under the 4.3% growth rate for all providers in the survey. APC productivity, measured in net work relative value units (wRVUs), grew 3.0% over the same period. A practice that still prices NP openings below PA openings, or the reverse, is pricing against a gap that AMGA's national data says has nearly closed.
Compensation is growing faster than production
Total clinical compensation across all providers in the survey rose 4.3% in 2025, while wRVU production rose only 2.4% and patient visit volume rose 2.0%, AMGA reported. Productivity gains funded only about half of the compensation increase medical groups paid out, meaning the rest came from somewhere other than more patients seen or more work performed.
The gap between pay growth and production growth was not even across specialties. AMGA's specialty breakdown shows radiology, anesthesiology, and pathology posting the largest compensation increase at 5.7%, against wRVU growth of 3.1% in the same group. Primary care compensation grew 3.7% while primary care visit volume fell 2.2%, a drop AMGA translates to roughly 60 to 90 fewer visits per physician over the year.
| Specialty group | Compensation growth, 2025 | wRVU growth, 2025 |
|---|---|---|
| Primary care | 3.7% | 2.0% |
| Medical specialties | 4.3% | 2.0% |
| Surgical specialties | 3.2% | 3.1% |
| Radiology, anesthesiology, pathology | 5.7% | 3.1% |
| Advanced practice clinicians | 4.1% | 3.0% |
Source: AMGA, 2026 Medical Group Compensation and Productivity Survey (451 medical groups, about 188,000 providers), reported by HIT Consultant and TechTarget, June 2026.
Average wRVUs per patient visit rose from 1.86 to 1.94 across the survey population, AMGA found. Even where raw visit counts fell, the visits practices did see were coded and documented at a higher level than a year earlier.
For a group modeling next year's compensation pool, the specialty breakdown matters more than the survey-wide average. A group with a heavy radiology, anesthesiology, or pathology mix should plan for pay growth closer to 5.7%, not the blended 4.3% AMGA reports across all providers, while a primary-care-heavy group should model closer to 3.7%. Applying one growth rate across a mixed-specialty group risks underfunding the specialties where pay moved fastest.
Practices are hiring APPs faster than they can hire physicians
Separately from the AMGA survey, an MGMA Stat poll fielded August 18, 2026, with 288 applicable responses, found that 51.0% of medical groups added at least one net-new advanced practice provider role in the prior 12 months. Another 45.0% added none, with the remaining share unsure or reporting no APPs on staff to begin with.
Practice growth was the most common reason groups gave for adding APP roles, MGMA found, citing service-line expansion, added locations, and extended hours. Team-based care models and physician retirements or recruitment gaps followed as reasons. Among groups that did not add a role, no current need was the single most common answer.
Five years of catch-up in APP pay
The narrowing NP-PA gap sits inside a longer run-up in APP pay generally. Primary care NP compensation rose roughly 22.0% over the five years through 2026, and primary care PA compensation rose roughly 27.0% over the same five years, according to MGMA benchmark data cited in the same poll. In most categories, one-year APP compensation growth outran inflation.
Physicians who carry supervisory duties over APPs reported total compensation 15.0% to 21.0% higher than physicians without those duties, per the same MGMA data. For a practice weighing whether to add a supervising-physician role alongside new APP hires, that premium is a real line item, not a rounding error, set against the near-zero NP-PA gap the same data shows at the APP level.
A staffing plan that once treated NP and PA pay as two different line items now runs against a gap AMGA measures at under $400 nationally. The larger differences left in the compensation table sit between specialty groups and between supervising and non-supervising physicians, not between the two advanced practice roles themselves.
That shift also changes how a group compares NP and PA candidates for a net-new role. With cost nearly equal at the national level, a scope-of-practice fit and a state's supervision or collaboration rules carry more weight in the hiring decision than a pay differential that has, in AMGA's data, mostly disappeared.
Sources
- HIT Consultant, "AMGA 2026 Survey: Provider Compensation Rises 4.3% as Medical Groups Face Sustainability Warning," June 26, 2026
- TechTarget, "Provider compensation grew, but productivity outpaced pay," 2026
- MGMA Stat, "Beyond backfills: More than half of practices adding net-new APP roles," August 18, 2026
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