Physician Assistant Salary in Houston, TX 2026,
$137,240 Median | BLS + Market Data

Houston physician assistants earn a BLS median of $137,240/yr, or $65.98 an hour, across the Houston-Pasadena-The Woodlands metro, with a published band from $90,920 to $168,240. That is 1.0% above the US median for the occupation, and Texas applies no state income tax to it. BLS counts 2,390 physician assistants in the metro.

Yes, modestly — the metro runs 2.0% above the Texas statewide figure, reflecting the concentration of specialty and surgical practice here. Among peer metros Houston sits above Philadelphia at $135,640, Dallas at $134,900, Phoenix at $134,650, Austin at $134,550 and Denver at $134,540 — a narrow national spread that Texas's tax position widens considerably in Houston's favour.

Yes, and it is the clearest differentiator within the profession here. Surgical PAs first-assist in the operating room, manage pre- and post-operative care and take call, and in cardiothoracic, neurosurgical, orthopaedic and transplant practice that work is both technically demanding and hard to cover. This metro's surgical volume, concentrated in the medical centre district, supports a large number of those roles. Primary care and general outpatient PA practice pays around the median with better hours and no call.

Through the Texas Physician Assistant Board, which operates under the Texas Medical Board and licenses statewide. The route requires graduation from an accredited physician assistant programme — a master's-level qualification — passage of the national certifying examination, and ongoing NCCPA certification with periodic recertification. Practice in Texas is conducted under a collaboration or delegation arrangement with a supervising physician, the terms of which are set by regulation and by the employer. Houston issues no separate credential.

It is one of the better ones, for a specific reason: the range of specialty practice available in a single metro. A PA here can work in cardiothoracic surgery, transplant, oncology, neurosurgery, critical care or emergency medicine without relocating, which matters because PA careers are built on specialty experience rather than on a formal specialty credential. Add a 20.4% national growth projection, no state income tax and moderate housing costs, and the case is strong. The compressed top of this band is the honest limitation — specialty practice here has a definable ceiling.

The 75th percentile at $160,390 and the 90th at $168,240 sit unusually close together for a clinical profession. That pattern generally means a well-established market rate for the best-paid version of the job, with few employers willing to exceed it. For a PA in this metro the practical reading is encouraging in one way and limiting in another: the top of the profession here is reachable and knowable, rather than reserved for a lucky few, but there is not much beyond it. PAs seeking substantially more generally move toward administrative or industry roles rather than staying at the bedside.

Physician assistants are trained as generalists and certified as generalists — the national credential is not specialty-specific. What determines a PA's market value is the specialty experience they accumulate and how transferable it is. In a metro with this much specialty medicine, that creates an unusual opportunity: the ability to move between service lines early, find the one that suits, and then build depth. It also creates a risk, since deep specialisation in a narrow surgical field can make a later move harder. PAs here generally treat the first three years as the specialty decision.

Projections above 20% invite scepticism, but the mechanism behind this one is concrete. Physician training capacity is constrained and expensive to expand; PA training capacity is not, comparatively. Health systems facing rising demand and limited physician supply have responded by building clinical teams in which PAs and nurse practitioners handle a growing share of care under physician collaboration. Houston's health systems have done this visibly across hospital medicine, surgery and specialty clinics. The 180 openings a year pro-rated here reflects the national trend; the local specialty concentration suggests this metro will absorb more than its share.