Radiology Locum Pay Guide 2026: Rates, Teleradiology, and What to Negotiate

Radiology is one of the highest-compensating specialties in locum tenens, with in-person rates that regularly exceed those of most surgical disciplines and teleradiology creating a parallel market with its own distinct economics. Understanding how those two tracks differ — and where the real premium is — matters more in radiology than in almost any other specialty.

What Radiology Locum Pay Looks Like in 2026

The radiology locum market splits into two distinct tracks: in-person site coverage and teleradiology. Both are active markets in 2026, but they operate on different economics, different contract structures, and different risk profiles for the radiologist.

Broad market data for 2026 shows a wide observed range of $320-$520/hr across radiology locum assignments, which reflects how much modality mix, acuity, and coverage model drive the final number. The hub figures below represent the most consistently reported ranges across current locum postings and publicly available agency data.

These are intentionally wide ranges. The factors that push a radiology assignment toward the top or bottom of that band are covered in detail below.

Subspecialty Differentials: Where the Premium Is

General diagnostic radiology and interventional radiology do not pay the same, and the spread is meaningful enough to matter when evaluating assignments.

Current locum data, including AMN-sourced figures for neuro-interventional radiology and recent locum guide analysis, places IR and neuroradiology assignments in approximately the mid-$300s to mid-$400s per hour range, while general diagnostic work more commonly anchors around the low-$300s and up, depending on modality mix and urgency. One 2026 locum source places standard diagnostic radiology at or below $330/hr in some markets, while interventional and neuro-interventional work shows an observed range pushing into $350-$450/hr territory.

The honest caveat: clean subspecialty hourly differentials are not well-published in formal survey form. What exists is consistent in direction — IR and neuroradiology command a premium over general diagnostic — but the public data is not precise enough to report exact sub-bands as market-wide figures. When evaluating assignments, the modality breakdown matters more than the specialty label.

The practical implication: when evaluating a radiology locum contract, understand the modality breakdown before agreeing to a rate. A contract framed as “general radiology” that is 60% mammography and MSK reads is a structurally different economic proposition than one anchored in CT, MRI, and overnight cross-sectional coverage.

Call Pay, Overnight Premiums, and How They’re Structured

Radiology call pay in the locum context is real, but it is increasingly embedded in contract structure rather than shown as a separate line item. The most common expressions are:

• Higher per-study pricing for STAT and overnight reads — teleradiology vendors and hospital contracts both reflect this in modality-specific fee schedules
• Minimum shift guarantees — protecting the radiologist from low-volume overnight shifts that would otherwise produce poor effective hourly rates
• Premium night coverage blocks — scheduled differently than daytime coverage and priced accordingly
• Weekend and holiday premiums — still present in most in-person and hybrid contracts, though not always labeled as call stipends

The distinction from other specialties: in hospital-based specialties like emergency medicine, call pay is often a separate stipend. In radiology, especially in the teleradiology context, the premium is more often expressed through modality pricing tiers and shift minimums. Negotiate for both the rate and the minimum guarantee when coverage includes overnight or weekend blocks.

Teleradiology: A Separate Market With Its Own Economics

Teleradiology is not simply in-person radiology conducted remotely. It is a structurally distinct market with different pricing models, different platform economics, and a different set of competitive pressures.

Market Structure

The U.S. teleradiology market is dominated by a handful of major service platforms and national consolidators, including NightHawk, vRad, StatRad, and Radiology Partners. These platforms operate on two primary contract structures: shift-based coverage and volume-based (per-study) pricing. Per-study pricing is especially common in vendor contracts and outsourced night and weekend coverage arrangements.

The economics matter because volume-based models tend to compress rates when a vendor aggregates a large reading pool and spreads overnight coverage across many clients. The more the market functions as a national utility, the more pricing normalizes downward — unless the work is high-acuity, STAT, or clinically complex enough to resist commoditization.

Per-Study Pricing and What It Reveals

Public vendor pricing sheets offer a useful window into how the teleradiology market values different modalities, even though per-study fees are not direct physician compensation. Current pricing data from a U.S. teleradiology vendor shows CT starting around $40 per study, MRI around $60, mammography around $32, and MSK around $12. The spread across those modalities illustrates the underlying economic logic: complexity and liability drive per-study fees, and the same hierarchy applies to physician compensation.

A second model has become more prominent in 2026: wRVU-based productivity contracts. Some high-volume teleradiology platforms now advertise compensation in the $450-$500/hr range contingent on the radiologist hitting specific wRVU thresholds — typically around $45 per wRVU, with targets that require sustained reading volume to achieve. These arrangements can be competitive for high-output radiologists with a favorable case mix, but the effective hourly rate is contingent on productivity, not guaranteed. Evaluate the case volume and modality mix against the wRVU target before treating the advertised rate as a baseline.

A radiologist reading predominantly CT and MRI at a teleradiology platform is in a materially different earnings position than one whose volume is weighted toward mammography and MSK. This is the mechanism behind the “Rate Compression” label applied to teleradiology demand: the market pays for complexity, and commoditized reads are where compression shows up most clearly.

The AI Question

The most common question in teleradiology right now is whether AI reading tools are compressing rates by reducing the labor content of image interpretation. The current evidence is more nuanced than the concern suggests — but the nuance matters and it is not uniformly reassuring.

Current research, including work from radiologist and AI researcher Curtis Langlotz and others examining near-term AI deployment in radiology, points to a consistent directional finding: AI is most likely to reduce the time radiologists spend on routine tasks — particularly lower-complexity screening reads — rather than eliminate radiologist demand outright. The near-term effects are strongest in reporting workflow automation and simple modality reads. Total imaging volume continues to grow, which has historically offset productivity gains and kept demand for radiologist interpretation stable.

The risk that is less discussed in agency-produced content: if AI reduces the per-read labor content for commoditized studies, teleradiology platforms have both the incentive and the leverage to lower per-study fees for those reads. The radiologist absorbs the rate compression while the platform captures the efficiency gain. This is the dynamic that makes minimum shift guarantees and STAT premium structures worth negotiating specifically — they provide a floor against the scenario where AI-assisted workflow allows platforms to push through more volume at a lower per-unit rate.

The longer-term picture reinforces the subspecialty hierarchy already visible in the rate data: AI puts the most pressure on the reads that are already lowest-margin. Complex cross-sectional interpretation, IR procedural guidance, and high-acuity STAT coverage are where radiologist judgment is least replaceable and where rates have held. Radiologists whose case mix is concentrated in mammography, plain film, and routine MSK work face more structural exposure over a 5-10 year horizon than those anchored in subspecialty or procedural radiology.

Licensure: The Multi-State Problem Teleradiology Hasn’t Solved

This is the subplot that agency-controlled resources understate because the platforms have absorbed the cost and friction on the back end. For an independent locum radiologist considering teleradiology, the licensing structure is worth understanding directly.

Radiology does not have a functional interstate compact equivalent to the Interstate Medical Licensure Compact (IMLC). The IMLC does include radiologists who hold an allopathic or osteopathic license and meet the compact’s eligibility criteria — but the compact streamlines the application process, it does not eliminate state licensure requirements. Teleradiology coverage still requires licensure in the state where the patient is physically located at the time of imaging.

For a national teleradiology platform covering multiple health systems across multiple states, this means:

• The platform absorbs significant licensure, credentialing, and compliance infrastructure costs
• Individual radiologists working through a platform are insulated from that complexity but are also less portable as independent practitioners
• A radiologist building an independent teleradiology practice — rather than working through a vendor — faces multi-state licensure and credentialing as a meaningful operational burden

The IMLC does reduce some of the friction for qualifying physicians, and expansion of the compact continues. But teleradiology’s scale advantage for large platforms is partly derived from their ability to amortize licensing and credentialing costs across a large reading network — a structural advantage that independent practitioners cannot replicate without deliberate investment.

For more on multi-state licensure and the IMLC, see our guide: Multi-State Medical Licensing and the IMLC.

CMS and the 2026 Reimbursement Environment

The 2026 Medicare Physician Fee Schedule final rule includes changes to radiology payment that matter indirectly to locum rates. The ACR has flagged changes to payments for radiology tests and procedures in the 2026 MPFS, with ongoing analysis of the 2024 Physician Practice Information Survey (PPIS) data — which influences relative payment across specialties and practice expense components.

These reimbursement changes do not translate directly into locum hourly rate changes, but they influence the underlying economics that hospital systems, teleradiology vendors, and radiology groups use when negotiating coverage contracts. When reimbursement for a modality or procedure category tightens, the downstream pressure on staffing costs follows. It is worth tracking MPFS developments as background context for rate negotiation, particularly in assignments with a heavy Medicare population.

What Drives Rate in Radiology Locum Assignments

Across both in-person and teleradiology tracks, the variables with the most leverage on final rate are:

How Radiology Compares to Other Locum Specialties

For context across the specialties covered on this site:

Radiology sits near the top of the locum rate spectrum, with only anesthesiology producing comparable numbers — and anesthesiology’s top end is driven by high-acuity subspecialty work in a similar way. The radiology premium reflects both specialty scarcity and the operational value of a radiologist who can cover multiple sites remotely.

What to Negotiate

Standard locum rate negotiation principles apply in radiology, but a few points are specific to the specialty:

Modality mix disclosure: Before accepting a rate, ask for the expected case volume by modality. A rate that looks competitive for CT/MRI-heavy work is less competitive if 40% of reads are mammography or plain films. This is negotiable in some contracts and non-negotiable in others — knowing the breakdown lets you evaluate the actual economics.

Minimum shift guarantees: Critical in overnight and weekend assignments. Without a minimum read guarantee, a slow overnight can produce an effective hourly rate well below the stated figure. Push for a minimum number of studies or a floor guarantee on per-shift compensation.

STAT premium structure: If the contract includes STAT reads, confirm how they are priced relative to routine reads. This is where the rate meaningfully diverges in per-study models.

Malpractice tail coverage: Claims-made coverage and tail coverage requirements apply in radiology as in any other specialty. Confirm the coverage structure and who carries tail responsibility. See our malpractice coverage guide for detail on occurrence versus claims-made structures.

Credentialing timeline: Radiology credentialing at hospital systems can be slow. For in-person assignments, confirm the expected credentialing timeline before committing. Delays affect when you start earning.

Agency bill rate context: As with all locum assignments, the rate offered to you reflects what remains after the agency margin from the facility’s bill rate. Understanding how that spread works helps calibrate negotiation. See our bill rate breakdown guide.

The Teleradiology Decision

Teleradiology is an attractive proposition for radiologists who want schedule flexibility and geographic independence. The economics are real — the published rate ranges are competitive, and the ability to cover multiple sites without relocation has genuine value. The considerations worth understanding before committing to a teleradiology model:

Platform dependency vs. portability: Working through a major teleradiology vendor provides immediate access to volume, infrastructure, and multi-state coverage — but it also means you are operating within their pricing and scheduling structure. Direct teleradiology contracts offer more rate control but require you to manage licensure, credentialing, and malpractice independently across states.

Case mix drift: Teleradiology platforms often absorb volume from multiple sources, which means your case mix can shift over time. Monitor modality distribution in your actual reads against what was represented at contract negotiation.

AI exposure: The commoditized read categories — mammography, MSK, high-volume plain film — carry more long-term AI exposure than subspecialty and complex cross-sectional work. That risk does not materialize overnight, but it is a relevant factor in evaluating a platform that concentrates in those modalities.

Data Transparency Statement

Rate figures in this article are drawn from publicly available agency compensation data (AMN, CompHealth), current locum posting analysis, and publicly reported 2026 market figures. No formal 2025-2026 ACR standalone compensation survey was identified at the time of publication; this article will be updated when formal survey data becomes available. Subspecialty hourly differentials reflect current market direction based on available public sources and should be treated as indicative ranges, not survey-validated figures. Agency-sourced data is disclosed as such and cited with the understanding that agency surveys reflect their client mix and may not represent the full market. All rate figures are pre-tax and do not account for 1099 benefit and overhead costs. See our compensation structure guide for full context on gross-to-net pay translation.