LIVE MARKET·26 POSTINGS · LAST 180 DAYS

Clinical Nurse Specialist salary: $74.66/hr median.

Across 26 active postings · 2 titles with data · 7 states.

Browse Clinical Nurse Specialist salary titles in Advanced Practice Provider, including posting volume, median pay, state coverage, and role-level comparisons.

Titles
4
2 with data
Postings
26
Median /hr
$74.66
$155,296/yr
Coverage
7 states
9 employers
01·PAY DISTRIBUTION·P10 → P90

How Clinical Nurse Specialist pay is distributed across the market.

10% of postings pay under $58.67. The top 10% pay above $98.92.

P10
$58.67
P25
$70.00
P50
$74.66
P75
$82.75
P90
$98.92
P10
$58.67
$122,034/yr
P25
$70.00
$145,600/yr
P50 (median)
$74.66
$155,293/yr
P75
$82.75
$172,120/yr
P90
$98.92
$205,754/yr
03·STATE BREAKDOWN·n=26

Clinical Nurse Specialist pay across every state with live data.

01California CA8 postings
$77.13/hr
02Minnesota MN7 postings
$71.28/hr

Showing all 2 states with live data. Bars scale to the highest-paying state.

05·HIGHEST MEDIAN HOURLY·LAST 180 DAYS

Highest-paying job titles in the Clinical Nurse Specialist track.

RoleCategory · TrackMedian /hrP25–P75PostingsΔ pay
Critical Care CNSAdvanced Practice Provider · Clinical Nurse Specialist$82.00$81.25–$82.752— flat
Clinical Nurse Specialist (CNS)Advanced Practice Provider · Clinical Nurse Specialist$74.05$70.00–$80.5724— flat
06·HOW TO BECOME·CAREER PATHWAY·GENERAL TO ADVANCED PRACTICE PROVIDER (APP)

How to become a Clinical Nurse Specialist.

Advanced Practice Providers — Nurse Practitioners, Physician Assistants, Clinical Nurse Specialists, and Certified Nurse Midwives — diagnose, treat, prescribe, and coordinate care under their own license. APPs sit between RN-level bedside care and physician-level decision authority, with scope of practice that varies by state. The two dominant paths are the APRN route (NP / CNS / CRNA / CNM, built on an RN license) and the PA route (a separate medical-model master's program).

Education·Min: Master's degree · Preferred: Master's or Doctorate (MSN, DNP, MMS, MSPAS)

APRNs (NP, CNS, CRNA, CNM) start with a BSN and RN license, complete a graduate program in their chosen population focus, and pass the national certification exam (e.g. AANP/ANCC for NPs). PAs come through a separate medical-model master's program with no nursing prerequisite, then pass the PANCE. Both routes require state APP licensure / authorization to practice; collaboration and supervision rules vary widely by state.

DegreeDurationNotes
Master of Science in Nursing (MSN-NP)MSN2-3 years post-BSNStandard entry to Nurse Practitioner practice. Tracks include FNP, AGNP (primary or acute), PMHNP, PNP, NNP, and Women's Health NP.
Doctor of Nursing PracticeDNP3-4 years post-BSNTerminal practice degree for APRNs. Increasingly the entry-level requirement for some specialties (CRNA programs are doctoral-only as of 2025).
Physician Assistant Master'sMPAS / MMS / MSPAS27 months full-timeMedical-model program covering didactic plus 2,000+ supervised clinical hours across core rotations (IM, surgery, EM, peds, OB, behavioral health, family medicine).
Post-master's certificateCert1-2 yearsAdds a new APRN specialty (e.g. PMHNP) on top of an existing master's. Common for FNPs who want to add an acute-care or psych population focus.
Licenses & Exams·4 credentials
State APRN authorizationAdvanced Practice Registered Nurse license / authorityRequired
Issued by: State Board of Nursing

Required for NPs, CNSes, CRNAs, and CNMs. Built on top of the underlying RN license. Some states grant full practice authority; others require physician collaboration.

State PA licensePhysician Assistant licenseRequired
Issued by: State medical or PA board

Required for PAs in every state. Eligibility requires PANCE certification and graduation from an ARC-PA accredited program.

DEA registrationDEA prescriber numberOptional
Issued by: US Drug Enforcement Administration

Required to prescribe controlled substances. Almost universally required in practice for full-scope outpatient roles.

BLS / ACLSBasic / Advanced Life SupportRequired
Issued by: American Heart Association

Required for nearly all APP roles; PALS is required for pediatric specialties.

Optional Certifications·Pay boost where known
CredentialIssued byPay impact
AANP / ANCC NP certification
National NP board certification (population-focused)
Population-focused certification (FNP, AGNP, PMHNP, PNP, etc.) is the bridge from graduation to state APRN licensure. Not optional.
AANP or ANCCEntry requirement
PANCE / PANRE
Physician Assistant National Certifying Exam
PANCE is the post-graduation entry exam; PANRE recertifies every 10 years. Standard requirement for PA state licensure.
NCCPAEntry requirement
Specialty CAQ / sub-specialty
Certificate of Added Qualifications (PAs) or specialty certification (NPs)
Surgical, EM, cardiology, hospital medicine, psychiatry — both PAs and NPs can add formal specialty credentials. Often required for procedure-heavy roles.
NCCPA / specialty boards+5-15%
Career Path·5 steps
  1. 0-1 years
    New-grad APP / Fellowship

    Newly licensed NP or PA. Many systems run formal post-graduate fellowships (EM, hospitalist, surgery, primary care) for structured onboarding.

  2. 1-4 years
    Staff APP

    Independent clinical caseload within specialty. Builds procedural skill and patient panel.

  3. 4-8 years
    Senior / specialty APP

    Holds specialty CAQ or sub-specialty certification. Often a clinical preceptor for new-grad APPs and physician residents.

  4. 8+ years
    Lead APP

    Oversees APP scheduling, hiring, and protocols for a service line. Partners with the medical director on quality and throughput metrics.

  5. 12+ years
    Director of APPs / Chief APP

    System-level leadership over the APP workforce. Owns scope-of-practice strategy, credentialing, and APP-physician collaboration models. Often holds a doctorate (DNP or DMS).

Work Environment
Primary care and family medicineHospital medicine and inpatient servicesEmergency departmentsSpecialty clinics (cardiology, oncology, ortho, etc.)Surgical first-assistPsychiatric and behavioral healthUrgent care and retail clinicsTelehealth

Schedule. Outpatient APPs run business hours with limited call. Hospital and ER APPs typically work 12-hour shifts including nights, weekends, and holidays. Surgical APPs may take significant first-assist call.

Physical demands. Largely moderate — clinic-based roles involve frequent standing and EHR work; procedure-heavy specialties (surgery, EM, cardiology) add patient positioning, suturing, and longer stretches on your feet.

Job Outlook·Very Strong
+27-38% (2022-2032)

Nurse Practitioners and Physician Assistants are projected to be among the fastest-growing US occupations of the decade. Demand is driven by physician shortages (especially in primary care and rural areas), expanding scope-of-practice laws, and the shift of routine specialty care from physicians to APPs.

FAQ — Becoming this role·3 questions
NP vs PA — what's the difference?

Educationally: NPs come through nursing (RN → BSN → MSN/DNP, with a population focus); PAs come through a medical-model master's with no prior nursing experience required. Practice-wise the day-to-day is highly similar in most outpatient settings, though state laws differ: many states grant NPs full practice authority, while PAs almost always practice under a collaboration agreement with a physician. Choose the path that matches the educational pipeline you're already on.

How long does it take to become an APP?

PA: ~6 years total (4 years bachelor's + 27 months PA school + PANCE). NP: 6-8 years (BSN + 1-2 years RN experience + 2-3 years for MSN, or 3-4 for DNP). CRNA: 7-9 years (BSN + ICU experience + 3-year doctoral program).

Can NPs and PAs prescribe controlled substances?

Yes, both can register with the DEA and prescribe Schedule II-V medications, subject to state-level restrictions. A small number of states still limit some controlled-substance prescribing for NPs in restricted-practice jurisdictions.

05·BROWSE 4 ROLES·FROM CNA TO PERFUSIONIST

Every clinical role we track, with live pay ranges.

Showing 4 of 4 roles. Median is hourly P50 across active postings.Browse the full directory →