Physician Assistant Salary in Missouri 2026:
$135,130 Median

Missouri physician assistants earn a median $135,130 a year, or $64.96 an hour, per BLS OEWS May 2025, with a band from $82,690 at the 10th percentile to $169,650 at the 90th. That is only 0.6% below the national median of $135,880 — effectively the national rate. Note that the $82,690 tenth percentile is a part-time and partial-year artefact rather than an entry salary.

Joplin, at $150,300 — a rural south-west Missouri market, comfortably ahead of Cape Girardeau $141,080, St. Joseph $138,060, St. Louis $136,120 and Jefferson City $135,340. Small-market health systems bid above the metros for a nationally portable credential they cannot otherwise attract, and their posts carry neither the 1% city earnings tax nor the housing costs of St. Louis or Kansas City.

The Missouri State Board of Registration for the Healing Arts. Licensure requires graduation from an ARC-PA accredited programme and certification by the National Commission on Certification of Physician Assistants, plus a collaborative practice arrangement with a supervising physician that defines scope and prescriptive authority. The arrangement must be in place before practice begins.

The state's top rate is 4.8% following the 2024 reduction, with further phased cuts legislated — light compared with most states paying six figures for this role. The local layer is the Kansas City and St. Louis 1% earnings tax, which applies to wages earned in those cities by commuters as well as residents. At a $136,120 St. Louis salary it is a meaningful deduction, and it reinforces what the metro table already says about the smaller markets.

Yes. Missouri requires a collaborative practice arrangement with a supervising physician, which sets out the PA's permitted scope and prescriptive authority and carries the board's geographic and review provisions. In practice this means a PA taking a rural Missouri post must establish a collaborating physician relationship that satisfies the Board of Healing Arts, not only an employment contract — worth confirming before accepting an offer.

Because the PA credential is nationally portable and rural Missouri has nothing else to bid with. A physician assistant graduating with NCCPA certification can work in any state, and most would prefer a metropolitan post; a health system in Joplin or Cape Girardeau competing for that person offers money instead of amenity. That is why Joplin publishes $150,300 and Cape Girardeau $141,080 against St. Louis's $136,120. Two further factors compound it: neither market levies the 1% earnings tax that Kansas City and St. Louis impose on wages earned in the city, and housing costs are a fraction of the metros'. On a net basis the rural premium in Missouri is considerably larger than the gross figures show.

Specialty pooling, and a very low tenth percentile. The $121,680-to-$163,170 interquartile range is mostly a specialty spread — surgical and emergency practice against outpatient primary care — reported on one OEWS row. The $82,690 tenth percentile is a different phenomenon entirely: part-time and partial-year practice annualised as full-year employment. And the figure excludes call pay, productivity incentives and rural recruitment arrangements such as loan repayment, all of which are normal in Missouri and none captured in a wage survey.

Specialty, rurality and call. Specialty is the largest lever, moving a PA between the median and the $163,170 upper quartile. Rurality is the Missouri-specific second, and it works in the employee's favour here in a way it does not in most states — the state's critical access network pays above the metros. Call is third and is frequently underestimated: in a small hospital the coverage arrangement is compensated separately and can add materially to a base salary that already sits near the national median.