Internal Medicine Locum Tenens Rates
The national urban median for Internal Medicine locum work is $152/hr. The middle 50% of benchmarked rates spans $146–$159/hr.
Internal Medicine Locum Rate Benchmarks
Locum market rates, 2026.
P25
$146/hr
Median
$152/hr
P75
$159/hr
P90
$167/hr
Based on BLS OEWS public data and CMS geographic adjustments, processed through the LocumRates model.
Internal Medicine Rates by Region and Setting
| Region | Setting | P25 | Median | P75 |
|---|---|---|---|---|
| Northeast | Urban Hospital | $141/hr | $146/hr | $153/hr |
| Rural Critical Access Rural / CAH | $159/hr | $165/hr | $173/hr | |
| Midwest | Urban Hospital | $149/hr | $155/hr | $162/hr |
| Rural Critical Access Rural / CAH | $168/hr | $175/hr | $183/hr | |
| South | Urban Hospital | $146/hr | $152/hr | $159/hr |
| Rural Critical Access Rural / CAH | $164/hr | $171/hr | $179/hr | |
| Southeast | Urban Hospital | $150/hr | $157/hr | $164/hr |
| Rural Critical Access Rural / CAH | $169/hr | $176/hr | $185/hr | |
| West | Urban Hospital | $147/hr | $153/hr | $160/hr |
| Rural Critical Access Rural / CAH | $166/hr | $172/hr | $181/hr | |
| Southwest | Urban Hospital | $153/hr | $159/hr | $167/hr |
| Rural Critical Access Rural / CAH | $173/hr | $180/hr | $188/hr |
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Internal Medicine Locum Market Overview
Outpatient internal medicine locum demand is driven by FQHC, VA, multispecialty group, and rural clinic coverage gaps. The outpatient IM locum market is distinct from inpatient hospitalist work — lower hourly rates ($152 national median vs. $192 hospitalist) but different contract structure, patient complexity, and quality-of-life considerations. Daily patient volume cap is the single most important contract clause. For inpatient hospitalist locum rates and negotiation scripts, see the Hospitalist toolkit.
- Outpatient IM locum market covers FQHCs, VA, multispecialty groups, and rural clinics
- Daily patient volume cap is the most impactful contract clause — negotiate before signing
- Subspecialty background (cardiology, nephrology, endocrine) commands a premium at outpatient sites
- Chronic disease panel complexity justifies higher rates than general primary care coverage
Get the full Internal Medicine toolkit — 50-state rate tables, exact recruiter
scripts, contract protection, credentialing, and a first-offer-to-final-shift playbook.
What Affects Internal Medicine Locum Pay
Urban Hospital
- Daily patient volume cap is the most important clause — FQHCs and multispecialty groups can schedule 30+ patients without a defined ceiling; negotiate 18-22 per day
- Subspecialty training (cardiology, nephrology, endocrine) commands a 10-20% premium at multispecialty group and VA assignments where subspecialty consultations are handled at the generalist rate
- Procedure capability (joint injections, skin biopsies, treadmill stress tests) expands assignment eligibility and justifies a higher rate at sites that would otherwise refer out
- APP supervision scope must be defined — clarify how many NPs/PAs you oversee and whether chart co-signature is expected
Rural Critical Access
- Rural outpatient IM coverage at FQHCs and CAH-affiliated clinics commands a geographic premium — confirm travel and housing in writing
- Chronic disease panel complexity (diabetes management, anticoagulation, CHF) is higher in rural IM than rural FM — the patient population skews older and sicker
- EMR and charting expectations vary substantially at rural sites — clarify system and template requirements before committing
- Long-term recurring arrangements (quarterly blocks) are available at most rural IM sites and should be priced as a retention premium
Internal Medicine Contract Terms to Review
Items to review carefully before signing
- Daily patient volume not capped — the single most important outpatient IM contract clause
- APP supervision scope not disclosed — clarify how many NPs/PAs you co-sign for and at what liability
- RVU or productivity penalties embedded — some contracts penalize below-target volume on locum shifts
- Procedure expectations not defined — confirm whether joint injections, biopsies, or stress tests are expected
- Malpractice tail not included — confirm who pays, policy limits, and coverage scope
- Charting and EMR template requirements not specified — excessive documentation burden reduces effective hourly rate
Internal Medicine Negotiation Toolkit
Exact recruiter scripts, 50-state rate tables at P25/50/75/90, specialty leverage,
contract and malpractice protection, credentialing, and first-shift guidance.
$99 one-time.
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