VA Nurse Pay Scale Explained: How Title 38 Determines Your Salary at the Department of Veterans Affairs
By NurseCompensation Research Team · 2026-06-02 · 8 min read
VA nurses are paid under Title 38, not the General Schedule. Here is how the grade-and-step system works, what locality adjustments mean, and what VA RNs actually earn.
Title 38 vs. General Schedule
Most federal employees are paid under the General Schedule (GS), which has 15 grades and 10 steps. VA nurses are different. They are paid under Title 38 of the U.S. Code, which gives the VA authority to set nurse pay independently using a Nurse Professional Standards Board (NPSB) system.
Under Title 38, nurse pay is determined by:
- Grade (Nurse I through Nurse V)
- Step within each grade
- Locality pay adjustment based on geographic area
The Grade Structure
- Nurse I: Entry-level RN. Typically new graduates or nurses with less than 2 years of experience.
- Nurse II: Full performance level. Requires BSN or equivalent education plus demonstrated competencies.
- Nurse III: Senior level. Requires advanced practice, leadership responsibilities, or specialized expertise. Often charge nurses, clinical coordinators, or nurse educators.
- Nurse IV: Advanced management or expert clinical roles. Typically Nurse Managers, Associate Directors, or clinical specialists with advanced degrees.
- Nurse V: Executive level. Chief Nurse Officers, Associate Directors for Patient Care Services.
2025 Pay Ranges
The VA publishes locality pay schedules annually (effective January each year). For the 2025 pay year:
Base pay ranges (before locality adjustment) vary significantly. After locality adjustment, VA nurses in high-cost areas can earn substantially more than their base pay suggests.
For example, a Nurse III (the most common experienced staff nurse grade) in the San Francisco locality area earns considerably more than a Nurse III in a rural locality. The locality adjustment can add 20-45% above base pay depending on the area.
The VA publishes its complete nurse pay tables at va.gov/ohrm/pay, broken down by locality area. There are separate tables for each VA facility based on its geographic wage area.
Benefits Unique to VA Employment
Beyond base pay, VA nurses receive:
- Federal Employees Health Benefits (FEHB): Government subsidizes 70-75% of premiums
- Federal pension (FERS): Defined benefit plan based on years of service and highest 3 years of salary
- Thrift Savings Plan (TSP): Federal 401k equivalent with 5% automatic match
- 26 days annual leave per year (increasing to 26 after 3 years of federal service)
- 13 days sick leave per year (unlimited accumulation)
- Student loan repayment program: Up to $200,000 in student loan assistance over a career
- No malpractice insurance needed: Federal Tort Claims Act covers VA nurses
How to Estimate Your VA Salary
- Determine your likely grade based on education and experience
- Look up your locality area on the VA OHRM pay page
- Find the step you would enter at (typically Step 1 for new hires, though negotiation for higher steps is possible)
- Add the value of benefits (typically $25,000-$45,000 annually in total benefits value)
Comparing VA to Private Sector
VA base pay is often lower than private hospital base pay in the same city. However, the total compensation package (pension, TSP match, leave, loan repayment, job security) frequently makes VA employment financially competitive or superior for nurses planning long careers.
The breakeven point tends to favor VA employment for nurses who stay 10+ years due to the pension benefit. For nurses planning short tenures (under 5 years), private sector higher base pay typically wins.
Sources: VA Office of Human Resources Management (va.gov/ohrm/pay), Title 38 U.S. Code, 2025 Nurse Locality Pay Schedules.