Your contract is the most expensive document
you will ever sign without reading.

The non-compete can follow you for years.

A non-compete is a clause restricting where and when you can practice if you leave. The FTC's 2024 attempt to ban non-competes nationally was struck down in federal court, so as of 2026 they are still enforceable in most states. California, Minnesota, North Dakota, Oklahoma, and (largely) Colorado prohibit them. Indiana, Tennessee, and Florida actively enforce broad ones.

What matters in a non-compete:

• Geographic radius. Reasonable: 5 to 15 miles in urban areas, 25 to 50 in rural. Watch for "metropolitan statistical area" language, which can mean an entire city.
• Duration. 12 months is standard. 18 to 24 months is aggressive. Anything over 24 months is rarely enforceable but expensive to litigate.
• Scope. Does it cover all NP practice or only your specialty? "Any healthcare role" is overreach.
• Buy-out clause. Some contracts let you buy your way out for a flat fee, often 50 to 100 percent of annual salary. Negotiate this in.

The bonus that often pays $0.

Most NP contracts include a productivity bonus framed as upside. The math frequently makes it unreachable in year one. Three structures dominate:

• wRVU-based. You earn a per-wRVU rate above a threshold, typically $18 to $32 per wRVU above 4,200 to 5,200 wRVUs annually. New grads usually generate 3,200 to 4,000 wRVUs in year one. Bonus paid: zero.
• Collections-based. A percent of net collections above a target. Beware: collections lag 60 to 120 days, and write-offs can crush the math.
• Patient-volume. Per-visit bonus above a threshold (often $15 to $40 per visit above 18 per day average). Cleaner, but volume incentives push you toward unsafe pace.

Push for a year-one threshold set at 70 to 80 percent of expected steady-state volume, not steady-state itself. Otherwise the bonus is theoretical.

Occurrence vs claims-made is the line that matters.

Most NP contracts say "employer provides malpractice insurance." That is not enough information. The two structures behave very differently:

• Occurrence policy. Covers any incident that occurred during your employment, even if the claim is filed years later, even after you leave. No tail coverage needed. This is what you want.
• Claims-made policy. Only covers claims filed while the policy is active. The day you leave, coverage stops. Claims filed against you after you leave require tail coverage to be insured.

Roughly 70 percent of NP employer policies are claims-made because they are 30 to 50 percent cheaper for the employer. Which makes the next clause critical.

Tail coverage: who pays?

Tail coverage typically costs 150 to 300 percent of the annual premium. For a $1M/$3M NP policy that means roughly $4,500 to $12,000 out of pocket if you have to buy your own tail. Some contracts make tail the NP's responsibility. Some make it the employer's. Some make it conditional on length of service or reason for departure.

Read the exit before you read the entrance.

Your termination clause defines how the relationship ends. Three subsections matter:

• Without cause notice. Standard is 60 to 90 days from either side. Anything under 30 days favors the employer. Anything over 120 days locks you in too long.
• For cause definitions. "For cause" should require specific, documented breach. Vague terms like "conduct unbecoming" or "loss of confidence" let the employer fire you with cause and trigger tail coverage and signing bonus claw-backs.
• Garden leave. Some contracts pay your salary during your notice period but bar you from working. Helpful if you are starting a new job; restrictive if combined with a non-compete.

The fine print on time off.

2026 NP benchmarks for an outpatient role:

• PTO: 18 to 25 days year one, accruing toward 25 to 30 by year five
• CME days: 5 separate days plus $2,500 to $4,500 stipend
• Holidays: 6 to 8 paid, on top of PTO
• Sick leave: 5 to 10 days, sometimes integrated into PTO
• Licenses, DEA, board cert: reimbursed (push for this)
• Professional dues: reimbursed up to ~$1,000

Watch for "PTO inclusive of CME and sick" which is a common giveaway disguised as generous. 25 days that has to cover your bronchitis, your wedding, and your conferences is not 25 days of vacation.

The $15,000 you might owe back.

Signing bonuses for new NPs run $5,000 to $25,000, with $10,000 to $15,000 typical for outpatient and up to $35,000 in psych and rural. Almost all are subject to claw-back if you leave inside a defined window.

Standard claw-back: full bonus owed back if you leave within 12 months, pro-rated through 24 months. Aggressive claw-back: full bonus owed back if you leave within 36 months, no pro-rating. Some contracts also claw back relocation reimbursement, sign-on retention payments, and CME spend.