Psychiatrist Salary (2026): How Much Psychiatrists Make by Setting, Subspecialty and State

Psychiatrists in the U.S. make about $330,000 to $352,000 a year, depending on whose survey you read, and most land between roughly $300,000 and $400,000. That puts psychiatry above internal medicine and family medicine but well below the procedural specialties, even though HRSA projects that supply will meet only about half of the demand for adult psychiatrists in 2038.

This guide covers psychiatrist pay in 2026 by source, setting, subspecialty, state and career stage, with hourly pay, take-home pay after taxes, child and adolescent psychiatry, telepsychiatry and cash-pay practice. Figures come from Doximity, Medscape, SalaryDr, Marit Health, AMN Healthcare, the Bureau of Labor Statistics and HRSA, each labeled with its date.

What the Data Shows: Psychiatry Salary in 2026

Psychiatry compensation surveys show meaningful variation depending on methodology and what components of compensation are counted:

The middle 50 percent of SalaryDr's psychiatry reports fall between $327,500 and $365,000, and the 10th to 90th percentile range runs from $300,000 to $395,000 (100 approved, self-reported reports through September 23, 2026). SalaryDr drops outlier reports beyond 1.5 times the interquartile range, so these figures describe the typical market rather than the top earners in private-pay, concierge, and forensic work.

Survey averages and starting offers are moving at different speeds. The Doximity 2026 average of $350,786 is about 2.6 percent above the $341,977 Doximity reported for psychiatry in 2025. AMN Healthcare's recruiting data shows a steeper climb in starting offers: an average starting salary of $315,000 in 2025, up from $285,000 in 2024.

Most of SalaryDr's psychiatry reports include bonus or incentive pay — 79 of 100, or 79 percent — with a median bonus of $60,000 among those reports. This makes psychiatry's true total compensation meaningfully higher than the base salary figures most commonly cited.

How Much Psychiatrists Make per Hour

Psychiatrists on SalaryDr report working an average of 40 hours a week, one of the shortest weeks of any specialty. At the $351,800 median, that comes to about $169 an hour over a 52-week year, about the same per hour as neurologists, who earn more a year but work longer weeks.

Hourly locum and PRN rates run well above the salaried equivalent because they carry no benefits, paid leave or retirement match, and locum psychiatrists usually pay their own self-employment tax. Our locum tenens salary guide compares the two on an after-tax basis.

The Psychiatry Compensation Paradox: Massive Shortage, Middling Pay

This is the question every medical student researching psychiatry asks, and it deserves a direct answer: If psychiatrists are in such short supply, why does the pay still trail general surgery by about $150,000 a year?

The answer comes down to the structural economics of psychiatric practice — and understanding it explains both why the current compensation is what it is and why it is changing faster than almost any other specialty.

• •Reason 1: No procedures. Psychiatry is an almost exclusively cognitive specialty. A psychiatrist who sees 20 patients in a day and a surgeon who performs 4 complex procedures generate very different amounts of billable revenue per unit of time. The RVU system that drives physician compensation across most employed settings systematically undervalues cognitive and longitudinal care relative to procedural work. A 45-minute psychiatric evaluation generates far fewer RVUs than a 45-minute surgical procedure — regardless of the clinical complexity involved.
• •Reason 2: The 60-minute income ceiling. The 60-minute therapy hour creates a hard ceiling on volume-based income that no amount of demand can overcome. A psychiatrist doing primarily psychotherapy can see 6 to 8 patients in a day. A hospitalist at comparable training level sees 15 to 20. The cognitive intensity per hour may be equivalent, but the billable encounter count is not.
• •Reason 3: Payer mix and reimbursement rates. Psychiatric services have historically been reimbursed at lower rates than other physician services under both Medicare and commercial insurance — a disparity the federal Mental Health Parity and Addiction Equity Act was designed to address but has not fully corrected. A psychiatrist practicing in a predominantly Medicaid market faces reimbursement rates that make achieving $300,000 annual income from pure insurance billing genuinely difficult.

Why it is changing:

All three of these structural factors are being challenged simultaneously. Medication management visits — 20 to 30 minutes rather than 60 — allow higher patient volume without the income ceiling of full psychotherapy. Private-pay and cash-pay psychiatric practices bypass insurance reimbursement entirely, capturing the full market rate for psychiatric services from patients willing to pay out of pocket. And the severity of the shortage is finally forcing health systems and insurance companies to compete more aggressively for psychiatrists in ways that are moving compensation upward.

Psychiatry Salary by Practice Setting

The two largest self-reported datasets agree that setting moves psychiatrist pay less than the headlines suggest. On SalaryDr, private practice and hospital-employed psychiatrists average within about $6,000 of each other; on Marit Health, community health systems, government and self-employed psychiatrists all average between $335,000 and $349,000.

Private Practice and Cash-Pay Psychiatry

Psychiatrists turn down insurance more often than other physicians. In a 2014 JAMA Psychiatry study of 2009–2010 national survey data, only 55.3 percent of office-based psychiatrists accepted private insurance, against 88.7 percent of other specialists, and 43.1 percent accepted Medicaid. A 2019 follow-up in the same journal found psychiatrists' Medicaid acceptance fell from 48 percent in 2010–2011 to 35.4 percent in 2014–2015. Medicare shows the same pattern: KFF's 2024 analysis found psychiatrists make up 39.0 percent of the non-pediatric physicians who have formally opted out of Medicare, and 8.1 percent of psychiatrists have opted out, the highest rate of any specialty.

The economics are simple to sketch. As an illustration, a psychiatrist who charges $300 per medication management visit and sees 6 patients per half-day, four half-days per week, 52 weeks a year, collects $374,400 before rent, staff, malpractice and marketing, with no prior authorizations or payer contracts. A concierge or membership panel works the same way: 150 patients at $300 to $500 a month is $540,000 to $900,000 in gross subscription revenue.

Those are gross figures for full panels, and the survey data is more modest: SalaryDr's private practice average is $385,000 and Marit's self-employed average is $335,000. The limits are patient acquisition, which takes time and marketing, and the market itself. Cash-pay practices work best in metro areas with high household incomes and are much harder to build where most patients have Medicaid.

Hospital and Health System Employment

Hospital employment is the most common practice setting for psychiatrists and the baseline against which other settings should be compared. SalaryDr's hospital-employed psychiatrists average $379,205 (34 reports), with meaningful variation based on call requirements, productivity models, and regional demand.

The most important variable in employed psychiatry compensation is the patient volume model. Psychiatrists doing primarily 15-to-30-minute medication management visits can see 20 to 30 patients per day in a well-organized outpatient clinic — significantly more than those doing 50-to-60-minute therapy appointments. The per-RVU income generated by high-volume medication management often exceeds what a comparable therapist-psychiatrist hybrid model produces, despite lower per-visit reimbursement, simply because of encounter count.

Inpatient psychiatry commands the highest base compensation among employed settings due to the complexity of acute care and the 24/7 coverage requirements. Inpatient psychiatrists work in acute care hospitals, psychiatric hospitals, and residential treatment centers, often covering nights and managing involuntary holds, and call stipends are usually paid on top of base salary.

Telepsychiatry Salary

Telepsychiatry is one of the most misunderstood income topics in psychiatry. The intuitive assumption — that telepsychiatry platforms enable higher income by eliminating geographic constraints and allowing practice across multiple states simultaneously — is partially correct but incomplete.

SalaryDr's psychiatry career guide puts fully remote positions at about 10 to 15 percent below in-person roles, in exchange for geographic freedom and scheduling control. Hybrid schedules — for example, three on-site days and two remote days — are rapidly becoming the preferred model.

Part of the discount is competition: remote roles draw applicants from every state, platforms compete on price, and psychiatric nurse practitioners fill many of the same virtual visits at lower rates.

Where telepsychiatry truly shines is in flexibility and supplemental income. As an illustration, a psychiatrist who adds two evenings of telepsychiatry a week (about four hours in total, 50 weeks a year) at Marit Health's $231 PRN average adds about $46,200 a year before taxes. Check the employment contract first: many restrict outside clinical work, and the platform's malpractice coverage and the patient's state license both have to be in place.

The Interstate Medical Licensure Compact (IMLC) allows psychiatrists to hold medical licenses in multiple member states more efficiently — a meaningful enabler for telepsychiatry physicians who want to practice across state lines without navigating individual state licensing processes repeatedly.

VA and Government Employment

The Department of Veterans Affairs employs one of the largest psychiatrist workforces in the country. VA physician pay is set by federal pay tables with a market-pay component that varies by specialty and location; Marit Health's government and military psychiatrists average $340,000. The benefits are comprehensive: a federal pension, health insurance, malpractice coverage with no tail cost, and substantial loan repayment programs.

The VA's federal employment status makes it one of the most PSLF-friendly employers in medicine. Every VA psychiatrist is at a qualifying government employer by definition. Combined with IBR-based federal loan payments, VA psychiatrists with typical medical school debt of $250,000 to $350,000 can pursue PSLF forgiveness that adds $150,000 to $300,000 in tax-free value over the 10-year qualifying period — equivalent to $15,000 to $30,000 in additional annual compensation that does not appear in any salary survey.

The VA also offers the Education Debt Reduction Program (EDRP), which provides up to $200,000 in student loan repayment, paid at up to $40,000 a year. For psychiatrists with high student loan burdens, the combination of PSLF and EDRP at the VA is genuinely transformative.

Academic Psychiatry

Academic psychiatry pays the least of the settings SalaryDr reports — an average of $339,093 (32 reports) — in exchange for protected research time, teaching responsibilities, academic identity, and the complex case exposure that community and private settings rarely provide.

For academic psychiatrists at qualifying nonprofit medical schools and research institutions, PSLF eligibility applies on the same basis as VA employment. The academic salary discount is narrowed meaningfully when PSLF forgiveness is factored into the total compensation calculation for psychiatrists with significant federal student loan debt.

The Shortage That Is Changing Everything

No specialty is experiencing more structural workforce pressure than psychiatry, and that pressure is beginning to translate into compensation movement that the surveys have not yet fully captured.

HRSA projects a shortage of about 36,780 full-time adult psychiatrists by 2038, with supply meeting only half of projected demand. The Health Resources and Services Administration's 2025 workforce brief also notes that behavioral health needs have risen, that the COVID-19 pandemic made them worse, and that nearly half of U.S. adults with a mental illness went without treatment in 2024.

The same brief counts 40 percent of the U.S. population — about 137 million people — living in a Mental Health Professional Shortage Area as of December 2, 2025.

The practical implication for compensation:

In markets with acute shortages — rural areas, community mental health centers, correctional health systems, and federally qualified health centers — employers compete with signing bonuses, loan repayment and schedule flexibility as well as base pay. No national survey breaks psychiatrist pay out by shortage status, so ask recruiters for the local range and compare total value, not salary alone.

Telepsychiatry has widened who can reach those patients without relocating, though loan repayment programs set their own rules on where the psychiatrist and the patient must be, so confirm eligibility with the program before counting on it.

The National Health Service Corps loan repayment program provides up to $50,000 in tax-free loan repayment for a full-time, two-year service commitment at an NHSC-approved site in a HPSA. For psychiatrists, this program is widely accessible and frequently stackable with PSLF qualifying employment. A psychiatrist serving at a qualifying community mental health center is simultaneously qualifying for NHSC awards and PSLF forgiveness — a loan repayment combination that can eliminate $200,000 or more in student debt over a relatively short period.

Use our PSLF Calculator to model what loan forgiveness is worth in your specific situation.

Psychiatry Salary by Subspecialty

Subspecialty choice in psychiatry changes your opportunity set more than your salary. The self-reported data shows no subspecialty with a consistent pay premium; the bigger differences come from setting and from outside work such as forensic consulting.

Child and Adolescent Psychiatrist Salary

Child and adolescent psychiatrists (often searched as pediatric psychiatrists) average $337,343 on Marit Health, with a median of $322,727 across 179 self-reported salaries (October 2026). The middle half earn between $291,319 and $382,140. SalaryDr's smaller sample puts the median at $357,500 (20 reports) for an average 41-hour week.

That is roughly the same pay as general psychiatry, not the premium often quoted. On Marit, child psychiatrists average $12,457 less than all psychiatrists ($349,800); on SalaryDr, their median is $5,700 above the specialty-wide $351,800. What the subspecialty does offer is demand: HRSA's 2025 workforce brief projects a shortage of about 7,030 child and adolescent psychiatrists in 2038, with supply meeting about 61 percent of projected demand. The self-employed average is the one that stands out.

The fellowship adds two years at a fellow's stipend (some programs let residents start it in the fourth year of general psychiatry training), so the financial case rests on the job market and private practice options rather than a higher employed salary.

Forensic Psychiatry

Forensic psychiatry has the widest income range of any psychiatry subspecialty, from salaried forensic hospital and correctional psychiatrists to private consultants and expert witnesses who bill by the hour.

The high-earning forensic psychiatrists are those who have built a reputation as expert witnesses and consultants in civil and criminal litigation. Case review, deposition and testimony are billed hourly, usually at rates well above clinical pay, so even a modest case volume can add meaningfully to an employed base salary. Salary surveys don't capture this income.

Building an expert witness practice requires deliberate effort — establishing credibility through publications, testimony experience, and professional reputation — and typically takes several years after fellowship training. For psychiatrists interested in the intersection of medicine and law, the income upside is genuine.

Addiction Psychiatry

Marit Health's addiction medicine psychiatrists average about $313,000 (October 2026), below the specialty as a whole. Addiction psychiatry has seen its demand profile change dramatically as the opioid crisis evolved and buprenorphine prescribing became a standard component of primary care. The post-pandemic behavioral health crisis has accelerated demand for addiction psychiatry further, particularly for physicians who can manage co-occurring psychiatric and substance use disorders.

One emerging income opportunity in addiction psychiatry: the expansion of psychedelic-assisted therapy research programs. Ketamine infusion clinics have grown rapidly since 2020, and several psychiatrists have built practices around ketamine administration for treatment-resistant depression — combining psychiatry, anesthesia collaboration, and cash-pay practice economics. MDMA-assisted therapy and psilocybin research protocols are expanding the frontier further, creating subspecialty niches that did not exist five years ago.

Geriatric Psychiatry

The fastest demographic growth driver in psychiatry. The aging U.S. population — 1 in 5 Americans will be 65 or older by 2030 — creates sustained demand for psychiatrists who can manage late-life depression, dementia-related behavioral symptoms, and the complex psychopharmacology of elderly patients on multiple medications.

Geriatric psychiatry is a one-year fellowship with growing demand and a relatively modest pipeline. In markets with large elderly populations — Florida, Arizona, retirement community clusters — geriatric psychiatrists are among the most actively recruited physician specialists.

General Adult Outpatient Psychiatry

The baseline. A general adult outpatient psychiatrist in a hospital employed setting — seeing primarily medication management patients with some psychotherapy — lands at the middle of the specialty's compensation range. The income ceiling here is set by the employed wRVU model and does not expand without a practice model change.

The High-Earning Models: How Psychiatrists Break Above the Median

Related reading: See where psychiatry ranks in physician wealth in our Physician Net Worth by Specialty rankings.

The psychiatrists well above the median are rarely in employed positions at standard outpatient volume. They usually use one or more of five income strategies that salary surveys capture poorly.

• •1. High-volume medication management practice. A psychiatrist who structures their practice around 20 to 30-minute medication management visits rather than 45 to 60-minute therapy appointments can see 20 to 25 patients per day in an outpatient setting — over about 220 clinic days, 4,400 to 5,500 encounters a year. At $150 to $200 per visit average reimbursement, this generates roughly $660,000 to $1.1 million in gross collections before overhead. After 40 to 50 percent overhead in an outpatient psychiatric practice, net income of roughly $330,000 to $660,000 is achievable for a high-volume practice owner.
• •2. Collaborative care and CCBHC models. Certified Community Behavioral Health Clinics (CCBHCs) receive enhanced federal Medicaid reimbursement for comprehensive behavioral health services. A psychiatrist working within a CCBHC at a larger organization can earn market salaries while the organization captures the enhanced reimbursement premium — making CCBHC settings increasingly competitive for psychiatric physician compensation.
• •3. Telepsychiatry layering. As described above, four hours a week of PRN telepsychiatry at Marit's $231 hourly average adds about $46,200 a year, if the primary employment contract allows it.
• •4. Expert witness and consultation work. Particularly in forensic psychiatry, disability evaluations, and workers' compensation contexts, consultation work billed by the hour supplements clinical income significantly for psychiatrists who develop and market this expertise.
• •5. Psychedelic and neuromodulation-adjacent practice. TMS (transcranial magnetic stimulation) practices, esketamine (Spravato) administration centers, and ketamine infusion clinics operated by or affiliated with psychiatrists generate cash-pay and specialty reimbursement revenue that significantly exceeds standard outpatient psychiatric billing rates.

Psychiatrist Starting Salary and Pay by Career Stage

AMN Healthcare's recruiting data puts the average psychiatrist starting salary at $315,000 in 2025, up from $285,000 in 2024, with a typical range of $250,000 to $410,000. That is close to the bottom of the survey ranges above (SalaryDr's 10th percentile is $300,000), which fits a specialty where pay rises gradually with experience rather than jumping at partnership.

• •Residency (PGY-1 through PGY-4): Psychiatry residency is four years, paid on the hospital's resident stipend scale like every other specialty. Child and adolescent, forensic, addiction and geriatric fellowships add one to two years at fellow stipends.
• •New attending (years 1–3): Most offers sit near AMN's $315,000 average. Signing bonuses and loan repayment are common, especially in shortage markets, and are worth comparing on a total-value basis.
• •Mid-career: Income grows through productivity incentives, inpatient or call stipends, and leverage as a proven clinician. Moving to private practice is most common in this window.
• •Senior physician: The top of the range belongs to practice owners, established forensic consultants and psychiatrists in leadership roles; SalaryDr's 90th percentile is $395,000. The income curve is flatter than in procedural specialties, but so are the hours.

The Lifestyle Advantage: What Salary Data Doesn't Capture

One number that stands out in SalaryDr's data: 91 percent of the psychiatrists who answered the question (97 reports) say they would choose the specialty again. That figure reflects something that salary data does not quantify: the quality of practice psychiatry offers relative to its compensation.

The best lifestyle-to-demand ratio in all of medicine — no overnight call in most outpatient models, 40-hour weeks are standard, and you'll never lack for patients.

The financial comparison between a psychiatrist earning $350,000 working 40 hours per week with no call and a procedural specialist earning $600,000 working 60 hours per week with overnight call is not $350,000 versus $600,000. The effective hourly rate comparison is meaningfully different, and the longevity advantage — psychiatrists whose practice model does not physically wear them out by age 55 — compounds over a full career in ways that raw salary comparison does not capture.

Malpractice insurance costs are also dramatically lower in psychiatry than in procedural specialties, a cost that matters most to psychiatrists in private practice, who pay their own premiums.

Psychiatrist Salary by State and Take-Home Pay

State-level psychiatrist pay varies less than you might expect. Marit Health's state pages (self-reported, read October 2026) show averages within about $40,000 of each other across the large states below:

Taxes move the number you keep more predictably than the state moves your salary. At the SalaryDr median of $351,800, a single psychiatrist with no retirement deferrals takes home:

That is about $33,198 a year more in Texas than in California on the same salary, before housing costs. At a $400,000 salary, California's state income tax alone is about $33,336. Telepsychiatry adds an option few specialties have: a psychiatrist licensed in several states can serve patients in high-demand markets while living somewhere cheaper. Licensure follows the patient's location, and state tax rules for remote work vary, so check both before relying on the arrangement.

Run your own offer with our physician take-home pay calculator, and see every state in our physician salary by state guide.

What a Competitive Psychiatry Compensation Package Looks Like in 2026

Use the survey figures above as anchors: an offer near SalaryDr's $351,800 median or Marit's $340,000 median is market rate, and one near the $300,000 10th percentile needs a reason, such as academic time, a light schedule or strong loan repayment. Beyond base pay, compare:

• •Bonus structure: 79 percent of SalaryDr's psychiatry reports include a bonus, with a $60,000 median among them. Ask how the bonus is earned (wRVUs, panel size, quality metrics) and what share of current psychiatrists actually receive it.
• •Visit length and volume: a productivity contract built on 60-minute visits pays very differently from one built on 20- to 30-minute medication management.
• •Call and inpatient coverage: whether call is paid separately and how often it falls on you.
• •Loan repayment and PSLF: NHSC, VA EDRP and nonprofit employment can be worth more than a salary difference for psychiatrists with large federal loans.
• •Outside work: whether the contract lets you take telepsychiatry, PRN or forensic work on your own time.

Use our Contract Analyzer to evaluate any psychiatry compensation package against 2026 benchmarks.