Essential Psychiatry Subspecialties: Where is pay the strongest?

​​Psychiatry subspecialties are a diverse and essential set of services that many patients encounter in the mental health care system. From addiction and geriatric psychiatry, to acute care and forensic settings, different skill sets and experiences are required in each domain. This is ultimately reflected in psychiatry subspecialty compensation, which is an important consideration for many psychiatrists as they weigh their career options.

The average psychiatrist salary is currently just over $300,000 annually. But practicing in a psychiatry subspecialty can produce a higher income, especially for high earners and private or consultative providers who see higher acuity patients.

Psychiatry Subspecialties and Their Salary Ranges

​According to our 2024 Physicians Thrive Compensation Report, psychiatrists nationwide are earning a mean salary of $309,000, up 2.5% from the prior year. However, not all subspecialties necessarily earn more than general psychiatry. While specialization can open doors to unique roles and consulting opportunities, compensation varies widely depending on the setting, demand, and scope of practice.

Here is a breakdown of current U.S. salary averages for the following psychiatry subspecialties:

• Forensic Psychiatry: $266,404
• Staff Psychiatrist: $271,899
• Child and Adolescent Psychiatry: $271,421
• Adult Psychiatry: $262,164

​These figures represent a combination of base salary and performance incentives. Although subspecialists bring advanced training and experience, general psychiatrists often earn comparable or higher compensation on average—particularly those in private practice, administrative, or consulting roles. Subspecialists, however, may benefit from more consistent demand, specialized case types, or opportunities tied to academic or institutional settings.

General psychiatrists with hospital staff privileges can command fairly steady incomes across most practice settings. But psychiatry subspecialists who treat high-acuity or underserved patient populations, work in more remote or less-saturated markets, or maintain privileges across state lines via telepsychiatry are often able to negotiate higher compensation packages.

Why Forensic and Addiction Psychiatry Stand Out

​Although average salaries for forensic and addiction psychiatry do not always exceed those of general psychiatry, these psychiatry subspecialties can offer higher earning potential under specific conditions. Forensic psychiatrists who perform expert witness evaluations, legal consultations, or risk assessments in private practice may bill premium rates that lift their income well above national averages. However, those employed in hospitals or correctional systems often earn closer to standard psychiatry compensation.

Addiction psychiatry shows a similar pattern. The field is in high demand due to the ongoing national substance use crisis, with the Substance Abuse and Mental Health Services Administration (SAMHSA) reporting that 48.4 million Americans age 12 and older had a substance use disorder in 2024. However, many roles are hospital or community-based, keeping salary averages steady with the broader profession. Private-sector addiction specialists, particularly those who combine clinical work with consulting or program leadership, tend to be the top earners in this discipline.

Addiction psychiatrists are in high demand as treatment specialists for this population, especially in private practice and hospital-affiliated rehabilitation facilities. Many psychiatrists that supplement this work with side consulting, program management, or public sector contracting see their annual income shoot well above national averages.

Geriatric and Child Psychiatry: High Demand, Modest Compensation

Geriatric and child psychiatry are still highly in demand, which typically translates into a higher income. In this case, it is more a reflection of workforce shortages and reliance on public-sector jobs that is driving the demand. As of 2023, there are only 1,429 board-certified geriatric psychiatrists in the U.S., which sustains steady reimbursement levels, particularly in hospitals and academic centers.

Similarly, the American Academy of Child and Adolescent Psychiatry notes that 72% of U.S. counties have no child psychiatrist. This is a severe access gap that keeps demand strong. Compensation in these roles, however, often mirrors general psychiatry due to heavy involvement in healthcare systems, telepsychiatry networks, or insurance-regulated settings.

How Salary is Affected by the Role of Setting in Psychiatry Subspecialties

Practice setting will also impact how much psychiatry subspecialties make. Private practice or consultative work will usually have the highest earning potential, thanks to greater case volume and billing flexibility. A subspecialist employed by a hospital will typically take home a slightly lower income in exchange for those conveniences.

Our 2024 compensation report found that psychiatrists in private practice earn an average of $30,000 to $45,000 per year more than psychiatrists employed by a hospital. Forensic and consultation-liaison psychiatrists particularly benefit from private-sector arrangements, as the direct fee-for-service model lets them bill for their evaluation, deposition, or expert reports.

Psychiatry subspecialties that are hospital-based typically have lower pay but are often provided other benefits like loan repayment, malpractice coverage, or academic appointment. The tradeoffs between autonomy and stability will depend on career stage, geographic considerations, and other personal priorities.

Experience, Location, and Dual Specialization

Experience is another one of the top drivers of earning potential among psychiatry subspecialties, with senior physicians routinely outearning younger peers. Geography is a factor in psychiatrist compensation, with the top-paying states usually including Maine, Delaware, and Rhode Island with salaries north of $350,000 annually.

Conversely, markets with the highest concentrations of psychiatrists such as California and New York can report some of the lower average pay due to payer pushback and workforce saturation. Some psychiatrists also choose to further increase their earning potential through dual specialization. For example, by combining addiction and forensic work or by integrating telepsychiatry into a child or geriatric psychiatry practice, new referral streams and greater flexibility for panel management across state lines can be created.

Maximizing Income Across Psychiatry Subspecialties

Specialization can be a way to a substantially higher income. But to make that happen, careful contract negotiation, strategic career and practice planning, and long-term financial strategy are required. Doctors in any of the psychiatry subspecialties should consider more than base salary at productivity incentives, partnership track, work-life balance, and non-clinical opportunities like teaching, consulting, or telemedicine when evaluating positions.

Comprehensive planning also includes much more than compensation. In fact, disability insurance, retirement savings, tax optimization, and other personal finance elements are crucial to long-term financial health, but many physicians miss out on important benefits without expert guidance.

Physicians Thrive provides psychiatrists with the resources and guidance necessary to make informed financial and career decisions. Our contract review, insurance planning, and financial management services give doctors the tools they need to protect their income, ensure they are being paid fairly, and plan for a successful future. Contact us today.