Clinical Nurse Specialist Salary Guide

NurseJournal Staff
Updated April 23, 2024
Clinical nurse specialists earn high annual salaries consistent with other advanced practice nurse roles. Read on to learn about top-paying states and projected employment growth.
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A clinical nurse specialist (CNS) is an advanced practice registered nurse (APRN) who specializes in a particular population, setting, or condition. For example, you might specialize in oncology, pediatric, adult-gerontology, emergency, or mental healthcare. Most clinical nurse specialist salaries are over $100,000, making this a financially rewarding career.

This guide describes typical CNS salaries, prospects for salary growth, and how to increase your CNS earnings.

Average Salary for Clinical Nurse Specialists

Clinical nurse specialist salaries vary based on location, experience, concentration, and education. CNS salaries are generally in line with other APRNs, such as nurse practitioners (NPs). In fact, Payscale reports an average $99,850 salary as of February 2022 for NPs, with nurse midwives earning an average $100,050 salary.

CNS salaries are typically highest for doctor of nursing practice (DNP) graduates, those with more experience, and those working in high-demand locations.

Average Annual Salary

Source: Payscale, February 2022

Average Hourly Wage

Source: Payscale, February 2022

What Kind of Salary Growth Can Clinical Nurse Specialists Expect?

Almost half (48.9%) of CNS salaries are $100,001 or higher, and 6.5% are $150,001 or higher. As demand grows, CNS salaries are likely to increase at the same rate or faster. In addition, the National Association of Clinical Nurse Specialists (NACNS) endorses requiring all CNS professionals to earn a DNP by 2030, which could raise CNS salaries.

Annual Salary RangePercentage of Clinical Nurse Specialists
Less than or equal to $75,0006.5%
$75,001 — $100,00021.6%
$100,001 — $125,00029%
$125,001 — $150,00013.4%
$150,001 or more6.5%
Source: NACNS – The Role of the CNS: Findings from the 2020 Census

Highest-Paying States for Clinical Nurse Specialists

The U.S. Bureau of Labor Statistics (BLS) does not separate CNS salaries from other nursing salaries. However, its data about nurse practitioner salaries in general can provide a good indicator of where CNS salaries are likely to be highest.

California has the highest average NP salary at $145,970, followed by New Jersey at $130,890, Washington at $126,480, New York at $126,440, and Massachusetts at $126,050. The cost of living is high in these states, especially urban areas, so consider that when comparing CNS salary offers or planning where to practice.

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How Do Clinical Nurse Specialist Salaries Compare to Other Nursing Roles?

While APRNs earn more than RNs, CNS salaries are lower than most other APRN salaries. Nurse anesthetists, who earn the highest salaries, are the most likely to hold a DNP. Nurse midwives and nurse practitioners are most likely to be primary care providers.

Only 24.4% of clinical nurse specialists have prescribing authority, which might explain part of the gap between CNS salaries and other APRN salaries.

3 Ways to Increase Pay as a Clinical Nurse Specialist

If you want to become a CNS and earn more than the average CNS salary, you can either advance your credentials or find a practice setting with higher pay. The right choice for you depends on your goals and professional preferences.

1. Pursue Prescriptive CNS Roles

If you work in a state where clinical nurse specialists are eligible to apply for prescription authority, you often earn a higher CNS salary. According to NACNS, 24.4% of clinical nurse specialists have prescriptive authority.

The application process for prescription authority varies by state. It typically requires passing advanced courses in pharmacology and may require prescribing under a physician’s supervision, either for a set period or permanently.

You may need to apply separately for authority to prescribe controlled substances.

2. Earn a Doctor of Nursing Practice Degree

Earning a DNP is another way to increase your CNS salary potential. As of 2020, 15.6% of CNS professionals have a DNP, according to the NACNS. The NACNS also endorses a DNP as the entry-level degree for the CNS specialty by 2030.

3. Switch Practice Setting

If you are geographically flexible or able to change employers or workplace settings, you can often find a higher CNS salary in areas with higher demand. Outpatient nurses typically earn higher average salaries, as do nurses working in government settings.

Working in a designated Health Professional Shortage Area can result in a higher CNS salary, since the federal government subsidizes salaries to attract healthcare workers. The cost of living may also be lower in these areas.

Frequently Asked Questions About Clinical Nurse Specialist Salaries

What are the most popular practice areas for a CNS?

Most (42.4%) clinical nurse specialists practice in adult-gerontology care. Another 22.5% are in pediatrics, and 14.6% provide care across the age groups; 10.4% specialize in psychiatric mental health. Fewer (6.8%) work in women’s and gender-specific health or neonatal (3.3%) care.

What degree is required to become a CNS?

Currently, a CNS must have at least a master of science in nursing (MSN) degree. You can study in an online CNS program, on campus, or through a hybrid program. However, the NACNS endorses requiring a DNP for entry-level positions by 2030. This will drive CNS salaries higher, as it will increase the time and cost required to enter the profession.

What is the difference between a clinical nurse specialist and a nurse practitioner?

Both nurse practitioners and clinical nurse specialists must have at least an MSN and pass board certifications. However, nurse practitioners are more likely to provide direct care to patients as their primary care provider. Clinical nurse specialists focus on training and precepting nurses and nursing students and researching and implementing nursing best practices. Additionally, more states allow nurse practitioners to practice without a collaborating agreement with a physician.

Fewer states allow a CNS to prescribe medications or practice without a physician’s supervision. This is one of the reasons a CNS salary is generally lower than an NP salary.

Is becoming a clinical nurse specialist worth it?

Whether becoming a CNS is worth it to you depends on your professional and financial goals. CNS salaries are higher than RN salaries, but lower than other APRN salaries, with the average CNS salary at $93,860 and the typical NP earning a median of $114,510.

A CNS is more likely to precept students, consult with nurses, lead teams that research and implement evidence-based practice than provide direct nursing care to patients.

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