Physiatrist Salary (2026): What PM&R Doctors Earn by Setting, Experience and State

What physiatrists earn in 2026

The three figures span about $31,000. They differ for reasons that have nothing to do with physiatry itself. Doximity estimates full-time pay from a large online survey of its members and models the result; it reports an average, which a handful of high earners pull upward. Medscape also reports an average, from a smaller self-selected sample of its readers, and includes bonuses and profit sharing. SalaryDr collects individual pay reports, which skew toward physicians who are comparing job offers; its 38-report median is the least affected by outliers but rests on the smallest sample.

Three other sources you may see quoted don't give a usable PM&R number. The Bureau of Labor Statistics wage survey has no separate occupation for physiatrists; they fall in a catch-all "physicians, all other" group with many other specialties. MGMA and AMGA, the benchmarks most employers use, sell their specialty tables and don't publish a free PM&R figure (our guide to MGMA salary data explains how employers use them). And the American Academy of Physical Medicine and Rehabilitation runs its own member compensation survey, but the 2026 results had not been published when we checked in October 2026. Figures attributed to those sources on other websites are often several years old.

PM&R doctor salary vs. other specialties

PM&R ranks 26th of the 51 specialties in Doximity's 2026 report, above the middle specialty on that list ($376,234). The comparisons that matter most to medical students are the neighbors. Against family medicine and internal medicine, the other non-surgical fields with three- or four-year residencies, PM&R pays $51,194 and $36,960 more on Doximity's averages. Against neurology, which shares EMG and neuromuscular work, the gap is only $5,147.

The largest gap is with orthopedic surgery: about $320,618 a year. Physiatrists and orthopedic surgeons see many of the same back, joint and sports injuries, and many physiatrists work inside orthopedic groups. The difference is that surgery earns far more work RVUs and facility revenue than non-operative care, which is also why physiatrists who add procedures move up the range.

Starting salary: early-career vs. experienced physiatrist pay

No large survey publishes a verified starting salary for new physiatrists, so we don't quote one. SalaryDr's experience pages are the closest public data:

The mid-career median is 15.7% higher than the early-career one. Most of that difference comes from how employed physiatrists are paid: a guaranteed base for the first one to three years, then pay that follows production once a practice is built and procedure volume grows. Physicians who join a private group often take a lower salary until they become partners and start sharing practice profits. A first offer near the early-career figure is normal; one well below $350,000, SalaryDr's 25th percentile for all physiatrists, is worth questioning.

How physiatrists are paid

Most employed physiatrists receive a base salary plus a productivity bonus measured in work RVUs (wRVUs), the physician-work part of Medicare's fee schedule. Our wRVU guide explains how those formulas work. Three features are specific to PM&R.

• A low conversion rate. SalaryDr's PM&R reports show a median of $51 per wRVU, against $60 for all physicians on the site. At $51, earning the $390,000 median purely on production would take about 7,647 wRVUs a year; the 25th and 75th percentiles ($350,000 and $420,000) correspond to about 6,863 and 8,235.
• Procedures carry the volume. Office visits for chronic pain and function earn modest wRVUs per hour. Electrodiagnostic studies (EMG and nerve conduction), epidural and facet injections, joint and tendon injections, ultrasound-guided procedures and botulinum toxin for spasticity earn more. A physiatrist's procedure mix is the biggest single factor in where they land between those wRVU figures.
• Inpatient rehabilitation is paid differently. Physiatrists who cover inpatient rehabilitation facilities are often paid a salary with stipends for medical directorship, weekend rounding and call rather than a pure wRVU formula, because daily rehab visits generate limited wRVUs.

Medicare policy matters to PM&R pay more than to many fields. From 2027, physiatrists in selected markets are among the specialists in the low back pain group of Medicare's mandatory Ambulatory Specialty Model, which adjusts Medicare payments up or down based on cost and quality measures.

Physiatrist pay by practice setting

Private and group practice

The highest median, $405,000. Physiatrists in private spine, pain and musculoskeletal practices, or employed by orthopedic groups, do the most procedures and may share in ancillary revenue such as an EMG lab, imaging or physical therapy. Ask how those revenues are split before assuming the group's top earners are a guide to your pay. Our guide to buying or starting a practice covers ownership.

Hospital-employed

A median of $375,000. This covers inpatient rehabilitation units and freestanding rehab hospitals as well as hospital-owned outpatient clinics. Pay is steadier, call is more common, and directorship stipends can add meaningfully to the base.

Academic

A median of $360,000, about $45,000 below private practice. Academic physiatrists run the programs that need a large hospital: spinal cord injury, brain injury, pediatric rehabilitation and residency training. Most academic employers are nonprofit or public, so their years usually count toward Public Service Loan Forgiveness (see below).

Fellowships and subspecialties

PM&R doesn't require a fellowship, and most physiatrists practice without one. The common one-year options are pain medicine, sports medicine, spinal cord injury medicine, brain injury medicine, pediatric rehabilitation and neuromuscular medicine. No public source we could verify reports pay for each PM&R subspecialty separately, so we don't quote subspecialty salaries. What we can calculate is the price of the extra year.

A fellowship pays for itself when it leads to work that earns more: interventional spine and pain procedures are the clearest case. Fellowships that lead to academic or inpatient programs (spinal cord injury, brain injury, pediatric rehabilitation) are usually chosen for the work, not the money. If you're considering one, ask two or three employers in your target market what the fellowship changes in base pay and procedure privileges. Our fellowship worth-it guide runs the same math for internal medicine and pediatric fellowships, and our sports medicine physician salary guide covers the sports fellowship that physiatrists share with primary care.

Physiatrist pay and take-home by state

State-level PM&R data is thin. SalaryDr reports these medians for states with at least three reports:

What you keep is more predictable. A single physiatrist with no pre-tax retirement deferrals takes home:

At the Doximity average, the same salary leaves about $35,789 more a year in Texas than in California. A California job would need to pay roughly that much more just to match take-home, before housing costs. Our take-home pay guide covers every state, and our physician salary by state guide covers regional pay.

Hours, lifestyle and physiatrist pay per hour

Physiatrists on SalaryDr report an average of 44 hours a week (38 reports). At the $390,000 median, that's about $170 an hour over a 52-week year.

Per hour, PM&R lands close to neurology and allergy and ahead of internal and family medicine. Hours vary most by setting: outpatient spine and musculoskeletal practices tend to run weekday clinic hours with little call, while inpatient rehabilitation coverage brings weekend rounding and phone call. If the schedule matters to you, ask for the call schedule in writing.

Demand for physiatrists

The most detailed projection is a workforce model published in the American Journal of Physical Medicine & Rehabilitation (Dall and colleagues, "The Physiatry Workforce in 2019 and Beyond, Part 2"). It combined a 2019 survey of 616 board-certified physiatrists (a 30.1% response rate) with microsimulation of supply and demand.

• It estimated a national shortfall of 940 physiatrists (10.6%) in 2017, with wide variation by region.
• Supply and demand were projected to grow at nearly the same pace through 2030 (about 2,250 more physiatrists against about 2,390 more needed), leaving a shortfall of about 1,080 (9.7%) in 2030.
• The authors concluded that the gap would persist without more PM&R residency positions, and that more nurse practitioners and physician assistants would not close it.

For a job seeker, a persistent shortage shows up as leverage on signing bonuses, schedule and call rather than in the wRVU rate, which is set by the employer's benchmarks. Regions with fewer physiatrists are where that leverage is greatest.

PM&R training and what it costs

Physiatry training takes four years under the American Board of Physical Medicine and Rehabilitation: a first clinical year, then three years of PM&R. That is one year more than family medicine. Our resident salary guide has the stipend for each year.

Is the extra year worth it against family medicine? On Doximity's averages, the fourth training year at a PGY-4 stipend of $77,593 gives up about $167,448 in take-home pay compared with a first year as a family physician. PM&R then pays about $32,073 a year more after tax, so the extra year is earned back in about 5.2 years of practice (Texas, single filer, undiscounted). Over a full career the higher average more than covers it, but the case rests on pay staying above family medicine, and the gap varies by source.

Student loans and PSLF for physiatrists

The AAMC's median education debt for indebted 2025 graduates is $215,000. Paid over 10 years at 6.5%, that's about $2,441 a month, or 11.1% of a Texas physiatrist's take-home at the Doximity average, before interest that builds up during residency.

PSLF is a strong option for many physiatrists because so much PM&R work is in nonprofit settings: academic centers, nonprofit rehabilitation hospitals and the VA. Full-time work for a 501(c)(3) or government employer generally qualifies; work for a for-profit rehab chain or a physician-owned group does not. Check your employer with our PSLF employer guide, then compare forgiveness with refinancing in our physician student loan guide.

Negotiating a PM&R offer

1. The wRVU rate. Compare it with SalaryDr's $51 PM&R median, and ask what volume the bonus threshold assumes.
2. Procedure credit. Do EMGs, injections and ultrasound-guided procedures count toward your wRVUs, and will the employer provide fluoroscopy, ultrasound and procedure time?
3. Inpatient rehab duties. Are inpatient rounding, weekend coverage and medical directorship paid as separate stipends or folded into the base?
4. Ancillary revenue. In orthopedic and spine groups, ask whether you share in EMG, imaging or therapy income, and on what timeline.
5. Non-compete and tail. Musculoskeletal practices compete locally, so check the radius and length of any non-compete (our non-compete guide) and who pays malpractice tail coverage.
6. Loan terms. If you are on the PSLF track, confirm the employer's tax status in writing.

Use our contract analyzer to compare offers, and read our salary negotiation guide and contract red flags guide before you reply.

Sources

1. Doximity Physician Compensation Report 2026 (2025 data).
2. Medscape Physician Compensation Report 2026.
3. SalaryDr: physical medicine and rehabilitation salaries (38 reports through September 5, 2026), private practice physiatrists, early career and mid-career pay, and wRVU rates by specialty. Self-reported; accessed October 27, 2026.
4. Dall TM, et al. The Physiatry Workforce in 2019 and Beyond, Part 2: Modeling Results. American Journal of Physical Medicine & Rehabilitation.
5. AAPM&R 2026 Compensation Survey, American Academy of Physical Medicine and Rehabilitation (results not yet published at the time of writing).
6. American Board of Physical Medicine and Rehabilitation: training and certification requirements.
7. AAMC 2025 Survey of Resident/Fellow Stipends and Benefits (PGY-4 $77,593, PGY-5 $81,807), as tabulated in our resident salary guide; AAMC median education debt, class of 2025, as used in our student loan guide.