CRNA locum tenens — the realistic 2026 playbook
$200-$250/hr. 1099 contractor. Multi-state. Here's what nobody tells you before you start.
TL;DR
Locum tenens CRNA work in 2026 pays $150-$250/hr (median $200), translating to $360K-$500K gross for full-time hours. You're a 1099 contractor — you pay both halves of FICA, handle your own retirement, buy your own health insurance, and manage multi-state credentialing. The math works best for CRNAs without young kids, with paid-off student loans, and with geographic flexibility.
What locum CRNAs actually do
Locum tenens means filling temporary CRNA staffing gaps at hospitals, ASCs, OB units, and surgery centers — typically 1-4 week assignments, sometimes 6-12 week recurring contracts. You travel to the assignment, work the schedule the facility needs (call included or excluded depending on contract), then leave. Specific work is identical to staff CRNA — general, regional, MAC, OB, peds — only the employment structure differs.
Pay structure — hourly + extras
Hourly rates 2026: $150-$250/hr depending on geography + acuity + call burden. Median ~$200/hr. Travel + lodging always covered by the staffing agency or facility. Per diem usually $50-$75/day for meals. Mileage if driving. Many agencies offer signing bonuses for hard-to-fill assignments ($1K-$5K).
1099 contractor — the tax math
As an independent contractor, you owe self-employment tax (15.3% — both halves of Social Security + Medicare) on top of regular income tax. Quarterly estimated payments due 4/15, 6/15, 9/15, 1/15. Deduct: home-office portion, malpractice premiums, CE costs, travel between assignments, professional dues. Hire a CPA familiar with traveling healthcare providers — the deductions easily save the CPA fee. Set aside 30-35% of gross for tax + retirement.
Health insurance + retirement
No employer-sponsored insurance. Options: ACA marketplace (subsidies disappear above ~$60K income — full premium typically $800-$1,500/mo for family coverage). Health-sharing ministries (cheaper, religious + lifestyle restrictions). COBRA from previous employer (~$1,200/mo max 18 months). Retirement: open a Solo 401(k) — can shelter up to $23,500 employee + ~25% of net self-employment income as employer match, total cap $69,000 in 2025. SEP-IRA simpler but lower cap.
Multi-state credentialing — the operational drag
Every state you want to work in needs its own RN license, APRN license, and state controlled-substance license. Each license is 4-12 weeks of processing + $50-$300 in fees. Most full-time locum CRNAs hold 3-5 state licenses. Smart strategy: get licensed in eNLC (enhanced Nurse Licensure Compact) states first — single multistate license covers 35+ states' RN portion (APRN portion still requires state-specific application).
State board renewal directory →Malpractice — TAIL COVERAGE IS THE MOST EXPENSIVE MISTAKE
Two malpractice policy types: OCCURRENCE (covers any claim arising from work done during the policy period, regardless of when claim filed) and CLAIMS-MADE (only covers claims filed during the policy period). Claims-made requires a 'tail' policy when you stop the coverage — tail can cost 200-300% of annual premium. Always demand occurrence coverage from agencies; if claims-made, demand the agency pay your tail in writing. New grad locums frequently get stuck with $30K+ tail bills they didn't anticipate.
Best locum agencies — by reputation
Top-rated agencies for CRNAs in 2026: CompHealth, AMN Healthcare (formerly Med-Search), Cross Country Healthcare, Comp Health, Locum Leaders, Vista Staffing. Smaller boutique CRNA-specific agencies: Anesthesia Recruiters, MD Anesthesia. Always compare 2-3 offers per assignment. Negotiate the rate, the call schedule, and the housing quality. Walk away from agencies that won't put occurrence malpractice in writing.
When locum stops making sense
(1) Young kids — the travel kills you. (2) Geographic anchor (mortgage, partner's career). (3) Wanting predictable schedule. (4) Wanting employer benefits + retirement match. (5) Burned out — locum requires more administrative work than staff jobs. Most CRNAs do locum for 1-5 years then transition back to staff with the savings + experience.
Related reading
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Last reviewed 2026-05-19. Spot something inaccurate? Email hello@gasguide.app.