Hospice and Palliative Care Nurse Salary 2026: What End-of-Life Care RNs Actually Earn
By NurseCompensation Research Team · 2026-06-20 · 10 min read
Hospice RNs earn a median of approximately $80,530 per year nationally, while palliative care NPs can reach $152,842. Here is the full compensation breakdown for this growing specialty, including per-visit pay models and the CHPN certification premium.
Hospice and Palliative Care Nursing: The Compensation Reality
End-of-life and comfort care nursing represents one of healthcare's fastest-growing specialties — driven by an aging population and a growing recognition that palliative approaches improve outcomes and reduce costs. Here is what the compensation data shows across all levels of this specialty.
RN-Level Hospice Compensation
Registered nurses working in hospice and palliative care settings earn:
- Median annual salary: $80,530 (hospice RN)
- Average hourly wage: $44.36 (palliative RN, per Vivian Health 2025 data)
- Annual equivalent at average hourly: ~$92,270
- 25th percentile: $67,000
- 75th percentile: $91,500
- Entry-level range: $62,000-$70,000
The BLS reports palliative care nurses earn approximately $45.42/hour ($94,480 annualized) when classified under the broader home health and specialty nursing categories.
Advanced Practice: Hospice and Palliative NP Salary
Nurse practitioners specializing in hospice and palliative care command significantly higher compensation:
- Average total compensation: $152,842 (per Marit Health 2026 data)
- Glassdoor average: $126,426
- Compensation breakdown: 98% base salary, 1% bonuses, 1% other income
- Salary range: $110,000-$180,000 depending on setting and geography
The ACHPN (Advanced Certified Hospice and Palliative Nurse) credential is increasingly expected for NP-level positions.
How Hospice Pay Compares to Other Settings
| Setting | Median RN Salary | Difference vs. Hospice |
|---|---|---|
| Hospital (general) | $93,600 | +16% |
| Hospice | $80,530 | Baseline |
| Home Health | $78,000-$85,000 | -3% to +6% |
| Skilled Nursing Facility | $72,000-$78,000 | -3% to -11% |
| Outpatient/Physician Office | $70,000-$78,000 | -3% to -13% |
Hospice nursing typically pays less than acute care hospital roles but offers tradeoffs in schedule predictability and physical demands.
Pay Models in Hospice
Hospice nursing uses several distinct compensation structures:
Salaried positions (most common for full-time):
- Predictable income
- Standard benefits package
- Typical caseload: 12-15 patients for routine home hospice
Per-visit pay:
- Routine visit: $35-$55 per visit
- Admission visit: $100-$150
- On-call/after-hours: $50-$75 per visit + hourly on-call rate ($3-$8/hour)
- Death pronouncement visit: $50-$100
Per diem/PRN:
- $40-$55/hour without benefits
- Often used for weekend and on-call coverage
The 2025-2026 Hospice Salary & Benefits Report from the Hospital & Healthcare Compensation Service (conducted with the National Alliance for Care at Home) provides the most comprehensive benchmarking data for hospice-specific roles.
The CHPN Certification Premium
The Certified Hospice and Palliative Nurse (CHPN) credential, administered by the Hospice and Palliative Credentialing Center (HPCC), impacts compensation:
- Estimated premium: $3,000-$7,000 annually over non-certified peers
- Eligibility: 500+ hours of hospice/palliative nursing in prior 24 months
- Renewal: Every 4 years
- Employer reimbursement: Many hospice organizations cover exam fees ($400) and offer certification bonuses
Industry Workforce Trends
The hospice labor market shows mixed signals:
- Vacancy rates: 12.78% across hospice employers in 2025 (down from pandemic highs)
- Wage growth: 3.58% for hospice RNs in 2025 (slower than 2024's pace)
- Turnover: Generally lower than acute care (hospice nurses report higher job satisfaction)
- Demand driver: Medicare hospice benefit enrollment has grown consistently, reaching over 1.7 million beneficiaries annually
Major Hospice Employers and Their Pay
| Employer | Type | Approximate RN Pay Range |
|---|---|---|
| VITAS Healthcare | National for-profit | $75,000-$95,000 |
| Kindred/Amedisys | National for-profit | $72,000-$92,000 |
| Compassus | National for-profit | $70,000-$90,000 |
| Nonprofit/faith-based hospice | Local/regional | $68,000-$88,000 |
| Hospital-affiliated palliative | Health system | $80,000-$100,000 |
Hospital-based palliative care teams typically pay higher than freestanding hospice agencies because they are embedded within the acute care pay structure.
Geographic Variation
Hospice nurse pay follows general geographic wage patterns:
- Highest-paying states: California ($95,000-$110,000), Washington ($88,000-$100,000), Massachusetts ($85,000-$98,000)
- Lowest-paying states: Mississippi, Alabama, Arkansas ($55,000-$65,000)
- Rural differential: Many hospice organizations serving rural areas add mileage reimbursement ($0.655/mile IRS rate) plus drive-time pay, which can add $5,000-$10,000 to effective compensation
The Financial Case for Palliative Specialization
For nurses considering this path:
- RN to hospice RN: Minimal salary change (may be lateral or slight decrease from hospital)
- Hospice RN to CHPN-certified: +$3,000-$7,000/year
- RN to palliative care NP (with MSN): +$50,000-$70,000/year but requires 2-3 year graduate program
- ACHPN-certified NP: Top of the palliative pay scale at $150,000+
Sources
- Bureau of Labor Statistics, OEWS May 2025
- Hospice & Healthcare Compensation Service, 2025-2026 Salary & Benefits Report
- Marit Health, Hospice & Palliative Care NP Compensation 2026
- Vivian Health, Palliative Nurse Salary Data (August 2025)
- Hospice News, Workforce Trends December 2025
- National Alliance for Care at Home, Industry Benchmarks