When a hospital needs temporary clinical coverage, the solution is rarely one-size-fits-all. Two models have become cornerstones of the flexible healthcare workforce: locum tenens and travel nursing. Both fill gaps. Both rely on temporary providers. Both are managed through staffing agencies. But the similarities stop there.
For a healthcare facility weighing coverage options, the difference between locum tenens and travel nursing determines how quickly a gap can be filled, how much administrative work lands on the facility, and how much clinical continuity can be maintained. For a staffing agency, the two models involve entirely different operational workflows, compliance requirements, and growth outlooks. Understanding the distinction is not just academic. It has real consequences for how a facility manages its workforce and how an agency builds its business.
What Is Travel Nursing?
Travel nursing is a staffing model in which registered nurses (RNs) and some licensed practical nurses (LPNs) take short-term assignments at healthcare facilities outside their home area. Contracts typically run 13 weeks, though assignments can be as short as four weeks or extended beyond the original term.
Travel nurses are placed primarily to address facility-level staffing shortages, whether from seasonal demand, high turnover, or regional nursing scarcity. The model became widely known during the COVID-19 pandemic when crisis-rate travel nurse pay reached nearly $4,000 per week. Since then, pay has normalized significantly, averaging approximately $2,165 per week in 2026 as pandemic-era demand has subsided.
Travel nurses hold active state licensure in their home state and often benefit from Nurse Licensure Compact (NLC) agreements, which enable them to practice across participating states without obtaining a separate license in each one.
What Is Locum Tenens?
Locum tenens, from the Latin phrase meaning "to hold the place of," refers to licensed physicians, nurse practitioners, physician assistants, and other advanced practice providers (APPs) who temporarily fill clinical roles at healthcare facilities. Assignments can range from a single day to an open-ended engagement lasting many months.
Unlike travel nursing, locum tenens is not defined by geography or relocation. A locum provider might work across the country or might serve a facility 20 minutes from home. What defines the model is the temporary, independent-contractor structure and the specialized credentialing and privileging process that accompanies each assignment.
The locum tenens market is valued at approximately $9.6 billion in the United States and has grown every year since 2021, with SIA projecting continued growth of 5% in 2025 and 4% in 2026.
Locum Tenens vs. Travel Nursing: A Side-by-Side Comparison
|
Locum Tenens |
Travel Nursing |
| Provider type |
Physicians, NPs, PAs, CRNAs, other APPs |
RNs, LPNs |
| Typical assignment length |
One day to several months (open-ended) |
Four to 13 weeks |
| Licensing requirements |
State-specific license required for each assignment state |
NLC compact or individual state license |
| Credentialing |
Full facility privileging required; primary-source verification |
Credential verification; no facility privileging |
| Malpractice insurance |
Typically provided by staffing agency |
Varies; some agencies provide coverage, some do not |
| Independent contractor status |
Standard |
Varies by agency and arrangement |
| Market size |
~$9.6 billion (2025) |
~$14.2 billion (2025, post-pandemic normalization) |
| Market trajectory |
Growing consistently |
Declining from pandemic peak |
| Operational complexity for agencies |
High (licensing, privileging, compliance tracking) |
Moderate (credential verification, compact licensing) |
Key Differences Explained
Let's dive into the key differences between travel nursing and locum tenens in more detail. Below are the common questions about the two models.
1. Who Qualifies
The most fundamental difference between locum tenens and travel nursing is the type of provider each model applies to. Travel nursing is primarily a registered nurse model. Locum tenens applies to physicians, nurse practitioners, physician assistants, CRNAs, and other advanced practice providers.
That said, the line has blurred in recent years. As nurse practitioners and PAs take on more autonomous clinical roles, they increasingly appear in both pools. An NP might hold locum tenens placements at physician-level rates and with physician-level credentialing requirements, or they might work as a travel APP under a simplified travel nursing structure. The distinction matters significantly for agencies because it determines which compliance workflows apply.
2. Assignment Length and Structure
Travel nursing contracts follow a fairly standardized structure: typically 13 weeks, 36 to 40 hours per week, at a named facility. Extensions are common, but the assignment clock generally restarts.
Locum tenens assignments are far more variable. A radiologist might cover a facility for one weekend. A psychiatrist might fill a rural clinic position for six months while the facility conducts a permanent search. An emergency medicine physician might rotate across three facilities on a recurring per-diem basis. The flexibility is a feature, not a flaw. It is part of what makes the locum model attractive to providers seeking autonomy and to facilities facing unpredictable coverage needs.
3. Credentialing and Licensing Requirements
Credentialing compliance is where the two models diverge most sharply from an operational standpoint.
Travel nurses must hold an active state license and meet any specialty certification requirements for their assignment (for example, ACLS certification for an ICU assignment). The Nurse Licensure Compact streamlines multi-state practice for nurses in participating states, reducing administrative friction considerably.
Locum tenens providers face a more intensive credentialing process. Each assignment in a new state typically requires a full state medical license, a process that can take weeks to months depending on the state. Every facility requires its own set of privileges, which involves primary-source verification of the provider's education, training, work history, malpractice history, and references. Malpractice insurance must be in place before the first shift. If the provider has a DEA registration and prescribes controlled substances, that must be current and state-specific as well.
For staffing agencies, credentialing is the single most common source of placement delays in locum tenens. It is also one of the clearest points of differentiation between agencies that operate with purpose-built workflows and those that do not.
Did you know? Staffing software can make a huge difference in speeding time-to-start for locum tenens.
4. Malpractice Insurance
Travel nursing agencies vary in their approach to malpractice coverage. Some provide it as part of the placement package; others do not. Nurses are generally expected to carry their own professional liability insurance regardless, and the stakes are comparatively lower given the scope of supervised nursing practice.
In locum tenens, malpractice insurance is not optional, and the coverage needs to be structured correctly. Locum agencies typically provide occurrence-based or claims-made coverage with tail coverage included. Tail coverage is particularly important for locum physicians because it protects against claims filed after an assignment ends. Agencies that fail to secure adequate malpractice coverage, or that leave providers with gaps in tail coverage, expose both the provider and the facility to significant liability.
5. Pay and Compensation
Both models offer competitive compensation above permanent-staff equivalents, though the pay structures differ.
Travel nurses earn an average of approximately $2,165 per week in 2026, a combination of taxable hourly wages and tax-free housing and meals stipends. This represents a significant decline from pandemic peaks but remains above pre-2020 levels for most specialties.
Locum tenens providers earn on a daily or hourly rate set by specialty, geography, and demand. Physician locum rates vary widely by specialty, with high-demand fields like psychiatry, radiology, and emergency medicine commanding significantly higher rates. Because locum providers work as independent contractors and do not receive employer-sponsored benefits, their gross pay is structured to account for that gap.
6. Market Trajectory
The current market dynamics for the two models are moving in different directions, and that matters for agencies making investment decisions.
Travel nursing revenue peaked during the pandemic and has since contracted sharply as hospitals reduced premium-rate contracts and nurse supply stabilized in many markets. According to SIA, travel nursing revenue fell to approximately $14.2 billion in 2025, down from its highs, and roughly 73% of U.S. states now have a surplus of registered nurses.
Locum tenens, by contrast, has grown every year since 2021 and is projected to continue growing. The structural driver is the physician shortage, which the Association of American Medical Colleges (AAMC) projects will reach between 37,800 and 124,000 by 2034. Unlike nursing shortages, physician shortages cannot be resolved quickly by increasing educational capacity. The pipeline takes a decade or more to respond to demand signals. That makes locum tenens an essential, not optional, part of the healthcare staffing landscape for the foreseeable future.
For Hospitals and Healthcare Facilities: Which Model Do You Need?
The right model depends less on preference and more on the type of coverage gap a facility is trying to fill.
Travel nursing is typically the right choice when a facility needs bedside nursing coverage for a defined, predictable period. It is operationally lighter for the facility: travel nurses do not require facility-level privileging, the credentialing process is simpler, and the standardized 13-week contract structure makes workforce planning relatively straightforward. For hospitals managing seasonal surges, planned leave coverage, or persistent nursing vacancies in a market with normalized supply, travel nursing remains a reliable, well-understood mechanism.
Locum tenens is the right choice when the gap involves a physician or advanced practice provider, particularly in a specialty where permanent recruitment is slow or the local market is thin. It is also the better option when coverage needs are irregular or open-ended, as the locum model does not require a fixed contract term. Rural facilities and safety-net hospitals, in particular, rely heavily on locum providers because the compensation packages required to attract permanent physicians are often out of reach.
The more significant operational consideration for facilities is the credentialing and privileging timeline. In a hospital setting, locum tenens privileging typically takes between 30 and 120 days, depending on the facility's internal processes and the completeness of the provider's documentation. Facilities that have not built efficient credentialing intake workflows often find that the gap they needed filled urgently has grown significantly by the time the provider is cleared to work. This is one of the most preventable sources of lost revenue in temporary physician staffing.
That timeline reality has a direct implication for how facilities should think about their agency partnerships. The administrative friction in locum staffing, including manual credentialing, fragmented vendor communication, and slow privileging workflows, is one of the most commonly cited operational pain points for healthcare systems. Facilities that work with agencies using integrated, purpose-built credentialing technology consistently see faster time-to-start and fewer placement failures. The quality of the agency's operational infrastructure is not a back-office detail for a facility. It directly affects care continuity and revenue.
Looking ahead, the most forward-thinking health systems are no longer treating locum tenens as a reactive stopgap. They are incorporating it as a planned component of workforce strategy, using it to bridge permanent searches, pilot new service lines, and maintain access in underserved departments. That shift requires agency partners who can operate at a higher level of speed, compliance, and transparency than the traditional locum model has demanded.
For Staffing Agencies: Managing Both Service Lines
Agencies that operate in both travel nursing and locum tenens are managing two operationally distinct businesses under one roof. The candidate profiles are different, the compliance workflows are different, and the timelines are different. A travel nursing placement might close in days. A locum tenens placement that involves a new state license can take weeks.
The agencies that manage both well share a common characteristic: integrated technology. When candidate data, license and credential documents, compliance tracking, and scheduling all live in the same system, it becomes possible to manage the very different workflows of a locum physician and a travel RN without siloing teams or losing information in handoffs.
This matters because the two markets are converging in some important ways. Advanced practice providers are increasingly placed under locum frameworks, which means travel nursing agencies that want to serve the growing APP market need to build locum-level credentialing capabilities. And locum agencies that want to diversify beyond physicians need to understand the contract structure and licensing environment of travel nursing.
Agencies that invest now in technology platforms capable of handling both, as well as in operational expertise around credentialing, compliance, and provider experience, will be better positioned as the healthcare staffing market continues to evolve.
Did you know? Ceipal has a Healthcare ATS built to support every need of healthcare staffing agencies and hospitals looking to place locum tenens or travel nurses.
The Bottom Line
Locum tenens and travel nursing are complementary models, not competing ones. Both exist because healthcare facilities need flexible coverage and because clinicians increasingly want autonomy over how and where they practice. The differences in provider type, credentialing complexity, assignment structure, and market trajectory are real, and ignoring them creates operational risk for agencies and planning failures for the facilities they serve.
For healthcare staffing agencies, the clearest takeaway is this: locum tenens is growing, and the operational barriers to doing it well are real. The agencies that build the right infrastructure, including integrated technology, proactive compliance management, and specialty-specific expertise, are the ones that will win placements as physician shortages deepen over the next decade.
Optimize Your Locum and Travel Staffing Workflows With Ceipal
Whether your agency places travel nurses, locum physicians, or both, Ceipal's healthcare-focused ATS is built to support the full placement lifecycle from candidate sourcing and credential collection to compliance tracking and scheduling. Staffing firms use Ceipal to reduce time-to-start, eliminate data silos, and deliver a better experience for both providers and facilities.
Learn more about how Ceipal supports the healthcare industry.
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