The Locum Line Item: What Anesthesiologist, CRNA, and CAA Locum Tenens Coverage Costs in 2026, and When It Stops Being Temporary

Locum tenens coverage was designed to fill a vacancy while a permanent hire is found. In anesthesia in 2026, it increasingly fills the vacancy instead of the hire.

This post looks at the locum market for all three anesthesia roles: what anesthesiologists, CRNAs and certified anesthesiologist assistants are paid per hour on assignment, how that compares with permanent pay, where the spending is concentrated, and what signals tell a hospital or ASC that a temporary line item has turned structural. It builds on earlier posts on the stipend economy and why compensation benchmarks disagree.

How much does anesthesia rely on locum tenens coverage?

Anesthesia relies on locum coverage more than any other physician specialty. Nearly two-thirds of anesthesia positions used locum tenens coverage in 2025, the highest reliance on locum staffing of any physician specialty in the report, according to Medicus Healthcare Solutions' "The State of Anesthesia Care Delivery" as summarized by Becker's ASC.

The clinician side of the market is large. More than 9,000 anesthesiologists and CRNAs have taken locum tenens assignments alongside a permanent job or as a standalone career (Locumpedia). An earlier industry estimate put the share at approximately 10% of anesthesiologists and 4% of CRNAs working locums in addition to or instead of a full-time role (Stout, citing a May 2025 Medicus report).

The overall locum market is growing slowly even as anesthesia demand stays strong. Staffing Industry Analysts projects 4% growth for the locum tenens staffing market in 2026, and industry leaders interviewed by Locumpedia singled out anesthesia and radiology as specialties that "support entire service lines inside the hospital" (Locumpedia).

What do locum anesthesiologists earn per hour in 2026?

Locum anesthesiologists earn roughly $300 to $425 per hour in 2026, with peer-reported averages near the upper-middle of that band. Locumstory reports locum anesthesiologists earning $300 to $425 per hour in 2026, up from $300 to $400 in 2025, with assignments averaging 60 to 120 days on a Monday-to-Friday, 7am-to-4pm schedule (Locumstory).

Marit Health's peer-reported locum anesthesiologist average is $377 per hour across 89 salaries as of September 4, 2026, with academic settings at $363 and non-academic at $378 (Marit Health). Cardiac anesthesiology commands a premium: Marit reports a $438 per hour locum average, but from only 9 salaries (Marit Health).

Locumstory's own demand read is geographic: the Midwest and Southwest together account for more than half of current anesthesiology locum openings (Locumstory).

What do locum CRNAs earn per hour?

Locum CRNAs earn an average of about $229 per hour, within a published range of roughly $125 to $325. Marit Health reports a locum CRNA average of $229 per hour across 102 salaries, updated September 20, 2026, with academic at $225 and non-academic at $229 (Marit Health).

Published CRNA locum ranges are wide. Locumpedia cites a reported locum CRNA range of $125 to $325 per hour from Barton Associates, with the top of the band reserved for cardiac and OB coverage (Locumpedia).

CRNAs are also where most of the anesthesia locum dollars go. On the Locumsmart vendor management platform, CRNAs had the highest total locum expenditure of any specialty in 2025 at $180.9 million, and nearly 20% of all shifts added to the platform were for CRNAs (Locumsmart).

CRNA scarcity shows up in facility surveys as well. CRNAs are the hardest advanced practice provider role to fill nationally at 30% of facility leaders, rising to 49% in rural facilities, per CHG Healthcare's survey of 327 facility leaders conducted in Q4 2025 (Health IT Answers).

What do locum CAAs earn per hour?

Locum certified anesthesiologist assistants earn roughly $200 to $210 per hour on average, based on a small sample. Marit Health's locum anesthesiologist assistant page shows a headline average of $208 per hour and an all-employer-types figure of $203 per hour from 27 salaries, updated September 4, 2026, with academic at $222 and non-academic at $201 (Marit Health).

Posted CAA locum rates sit in the same range. DocCafe listed 78 locum and travel CAA jobs, including Aya Locums assignments at $185 to $195 per hour in Leland, North Carolina and $195 to $205 per hour in Round Rock, Texas (DocCafe).

The CAA locum market is structurally constrained by geography. CAA availability is limited to states and jurisdictions where CAA practice is authorized (Locumpedia), and Medicus counts more than 4,500 CAAs authorized in 22 states plus Washington, D.C., and Guam (Becker's ASC). A CAA-inclusive locum strategy is not available to a facility in a non-authorizing state at any price.

How does locum pay compare with permanent pay?

Annualized at 2,000 hours, locum hourly pay runs roughly 40% to 90% above permanent benchmarks for all three roles. The table below uses Marit Health's locum averages and the permanent benchmarks covered in last week's benchmarking post. The locum figures are what the clinician is paid, not what the facility is billed.

Role	Locum average (Marit Health, Sept 2026)	Annualized at 2,000 hours	Permanent benchmark	Locum premium
Anesthesiologist	$377/hr (n=89)	$754,000	$536,320 AMGA median total clinical comp, 2025	~41%
CRNA	$229/hr (n=102)	$458,000	$236,590 BLS median annual wage, May 2025	~94%
CAA	$203/hr (n=27)	$406,000	$250,600 BagMask advertised average base, Q2 2026	~62%

The comparison flatters permanent pay. Permanent figures exclude employer-paid benefits, payroll taxes, malpractice, and the recruiting and sign-on costs a permanent hire carries, while locum pay generally excludes those items and adds travel and lodging on the facility side.

The comparison also understates the facility's locum cost. The hospital pays a bill rate that includes the agency's margin, malpractice, credentialing, and travel. One locum marketplace asserts that "most locum tenens agencies mark up 40–50%" (LocumsOne), but that claim comes from a platform competing on lower margins, so the true figure for a given contract should come from the invoice rather than a blog.

When does locum coverage stop being temporary?

Locum coverage has become structural when the same line has been filled by rotating locums for longer than it would have taken to recruit a permanent hire. Locumstory's 60- to 120-day average anesthesiology assignment length is a useful yardstick: a position covered by three or more consecutive assignments has been locum-staffed for most of a year (Locumstory).

Locum rates also leak into permanent pay. Surgical Directions describes locum tenens utilization as "one of the largest contributors to rising anesthesia expenses" and notes that "higher locum rates place upward pressure on permanent compensation expectations, forcing hospitals and anesthesia groups to increase salaries, signing bonuses, and recruitment incentives" (Surgical Directions).

Locum costs are increasingly passed straight to the hospital through the coverage contract. Stout reports that anesthesia groups short on staff seek additional reimbursement for locum coverage "either through passthrough reimbursement of actual locums costs or additional fixed per locum-shift payments," while hospital administrators often negotiate for more balanced risk sharing (Stout).

Rural facilities are pulling back even where the need is greatest. In CHG's survey, 25% of rural facilities plan to reduce advanced practice provider locum usage in 2026, the highest reduction rate of any region, while 23% of urban facilities plan to increase it (Health IT Answers). That divergence points to budget limits rather than falling demand.

What should hospital and ASC leaders track?

Four measures separate a locum bridge from a locum dependency:

• Consecutive locum months per line. Any anesthesia line filled by locums for more than six consecutive months deserves a permanent-hire business case.
• Locum share by role. A CRNA-heavy locum mix is where the largest dollars concentrate, based on Locumsmart's $180.9 million CRNA expenditure figure.
• Bill rate versus clinician rate. Ask agencies for the split; the gap is negotiable in a way the clinician rate often is not.
• Pass-through exposure in the group contract. A stipend that floats with locum usage transfers the group's recruiting risk to the facility.

A note on the data

Locum rate data is thinner than permanent compensation data. Marit Health's locum averages are voluntary clinician submissions with small samples of 9 to 102, and the headline CAA average of $208 differs from the $203 all-employer figure on the same page; a secondary guide attributes a roughly $215 CAA average to an earlier Marit reading. Locumstory, Barton Associates and LocumsOne are staffing-industry sources, and Medicus Healthcare Solutions, the source of the two-thirds locum reliance and CAA supply figures, is a locum staffing firm with a commercial interest in these findings. Locumsmart's anesthesiology growth figure of 271% was not reproduced above because the platform itself almost doubled in size in 2025 and did not specify whether the figure measures spend or shifts. The 10% and 4% locum participation shares come from a May 2025 report and may be dated. CAA authorization counts differ across sources: Medicus reports 22 states plus D.C. and Guam, while other state trackers report different counts. Annualized figures assume 2,000 hours and are illustrative, not a measure of what any clinician actually earns in a year.