Best Locum Tenens Companies in 2026: How to Compare Them
Every locum tenens company says it is fast, careful, and easy to work with. The differences show up in the agreement and on the invoice. Here is how the market is organized, what each kind of firm is good at, and the six questions that sort them.
A hospital administrator comparing locum tenens companies is usually doing it under pressure: a resignation with thirty days' notice, a leave that starts next month, a program that cannot open without a provider. The comparison gets made quickly, on the strength of a sales call, and the terms get read after the provider has started. This guide is the comparison we would want a client to make in advance, including the questions where our own answers are not the strongest in the market.
How the locum tenens market is structured
The market has three tiers, and the right one depends on what you are covering.
The national firms
CompHealth and Weatherby Healthcare, both part of CHG Healthcare, LocumTenens.com and Jackson & Coker, both part of Jackson Healthcare, AMN Healthcare's locum division, and large independents such as Barton Associates and Medicus Healthcare Solutions. These firms have the deepest benches in the industry and a consultant for nearly every subspecialty. If you need a pediatric cardiologist for six weeks in a state with a slow licensing board, the national firms are the most likely to have one already licensed. The trade-offs are structural: a large account team with handoffs between the sales consultant, the credentialing team, and billing; standardized agreements that favor the firm on cancellation and conversion; and a bench so large that your request competes with hundreds of others for the same provider.
Specialty and regional agencies
Firms built around one specialty, such as anesthesia, emergency medicine, or psychiatry, or around one region. Their benches are smaller but better known to the people placing them, which shows up as fewer surprises on the first day. Terms are usually negotiable because the agreement was written by someone you can reach.
Recruiting firms with a locum arm
Permanent placement firms that added interim coverage because their clients kept asking for it. MedStaff Locum Tenens is one of these. The bench is drawn from clinicians the firm already recruits for permanent roles, which makes it strong in the specialties the firm places most and thin outside them. The advantage is that the locum and the permanent search run in one place, with a conversion path that is already in the agreement.
What the large companies do well, and where smaller ones win
Give the national firms their due. Breadth of specialty, licensed providers in more states, 24-hour coverage lines, travel desks that book flights and housing without your involvement, and the experience of having handled every edge case. For a multi-site system filling a dozen needs at once, that scale is the product.
Smaller agencies win on three things. First, the terms. A six-page agreement from a firm whose owner you have spoken with can be changed; a national firm's standard agreement mostly cannot. Second, the provider. A smaller bench means the agency knows the provider it is sending, which is worth more than a larger bench when the question is whether this psychiatrist will be fine in your community mental health center. Third, the contact. One coordinator who answered the first call, wrote the Work Order, and will pick up on a Sunday when the provider's flight is cancelled.
The six questions that expose the differences
Ask every company the same six questions and compare the written answers. The answers are what you are buying; the sales call is not.
1. Is the bill rate all-inclusive?
Some companies quote a rate and add malpractice, a credentialing fee, travel handling, and an administrative line on the invoice. Others quote one number that covers provider pay, their margin, and malpractice, with travel and lodging either inside the rate or itemized before you sign. The second is easier to budget and harder to inflate. Ask for a sample invoice.
2. How many business days to a complete credentialing file?
The slowest step in any assignment is the medical staff office waiting on documents. A good company commits to a number in the agreement and delivers a file where every item is primary-source verified with evidence attached. “As fast as possible” is not a commitment. Five business days from the provider's acceptance is the standard we hold ourselves to; some national firms match it, and some do not put a number in writing at all.
3. What are the malpractice limits, and who carries the tail?
$1 million per occurrence and $3 million aggregate is the common standard. The question underneath is whether the policy is occurrence-based, which covers a claim whenever it is filed, or claims-made, which covers only claims filed while the policy is active and needs a tail afterward. For a locum provider who was at your facility for eight weeks two years ago, the tail is the only thing standing between you and an uninsured claim. Ask who pays for it and for how long.
4. What happens when the provider leaves early or does not show?
It happens, at every company, in every specialty. The difference is what the agreement says. The right answer is a replacement from the original need, started the same day, with no charge for the time not worked. The wrong answer is a new search at a new rate and an invoice for the week the provider did not arrive.
5. What is the cancellation schedule?
Needs change. A permanent hire signs early, a census drops, a grant ends. A good company has a cancellation schedule by notice period that you can read before you sign a Work Order: nothing owed beyond a certain notice, a week of guaranteed hours inside that, two weeks inside a shorter window. “Case by case” means the case will be decided after you have cancelled.
6. Who is our contact for the whole assignment?
At most national firms the person who sold the assignment is not the person who runs it. That is not wrong, but you should know it. At a smaller agency the coordinator who wrote the Work Order is the one who answers when the provider's license renewal is late. Ask for the name and the phone number before you sign.
A scorecard for comparing proposals
Put each company's written answers into a table like this one. The pattern is usually visible by the third row.
| Term | A good answer | A warning sign |
|---|---|---|
| Bill rate | All-inclusive, in writing before you commit | Rate plus a list of extras on the invoice |
| Credentialing file | A committed number of business days | "As fast as we can" |
| Malpractice | Limits stated; occurrence, or claims-made with the tail carried | "Covered" with no limits given |
| Provider leaves early | Replacement from the original need; no charge for time not worked | Silence, or a new search at a new rate |
| Cancellation | A schedule by notice period you can read | "Case by case" |
| Your contact | One named coordinator for the assignment | A sales rep who hands you to a queue |
| Conversion | Fee stated, credited for hours worked, with an end date | A flat fee with no credit, or a vague anti-solicitation clause |
Who should choose which
- A rare subspecialty, a short start window, or a dozen needs at once: start with a national firm. Breadth is the product and you need it.
- A single provider in a common specialty, especially psychiatry, primary care, hospital medicine, or advanced practice: a specialty or regional agency, or a recruiting firm with a locum arm, will usually be faster to a confirmed Work Order and easier on the terms.
- Coverage you expect to turn into a permanent hire: a firm that does both, so the conversion terms are written before the provider starts and the permanent search can run in parallel.
- A whole department you want run for you: that is outsourced staffing, not locum tenens, and a different kind of company.
Where MedStaff Locum Tenens fits
Honestly: we are the third tier. Our bench is strongest in behavioral health, primary care, hospital medicine, and advanced practice, because those are the searches MedStaff Nationwide runs every day, and thinner in surgical subspecialties. What we offer against the national firms is the agreement and the contact: one all-inclusive rate on a Work Order both sides accept electronically, the credentialing file in five business days, $1M/$3M occurrence coverage with the certificate before the first shift, replacement at no charge for time not worked, a cancellation schedule you can read, a conversion fee that declines to zero at 2,080 hours, and one coordinator for the assignment. Those answers are on the locum tenens agency page, in writing, which is where every company's answers should be.
Frequently asked questions
- What are the biggest locum tenens companies?
- The largest national firms are CompHealth and Weatherby Healthcare, both part of CHG Healthcare; LocumTenens.com and Jackson & Coker, both part of Jackson Healthcare; AMN Healthcare's locum tenens division; and independents such as Barton Associates and Medicus Healthcare Solutions. Below them are several hundred regional and specialty agencies, including MedStaff Locum Tenens.
- Is a bigger locum tenens company better?
- Bigger means a deeper bench and more specialties, which matters for a hard-to-find subspecialist or a large multi-site program. It also means a larger account team, more handoffs, and standardized terms. For a single provider in a common specialty, a smaller agency with a named coordinator is often faster and the terms are easier to negotiate.
- How much do locum tenens companies charge?
- An hourly or daily bill rate for the provider's time. The rate varies by specialty, setting, state, schedule, and notice, and it should be all-inclusive: provider pay, the agency's margin, and malpractice inside one number, with travel and lodging either arranged by the agency or itemized in writing before the assignment. Any company that will not put the rate and the extras in writing before you commit is the wrong company.
- What should be in a locum tenens agreement?
- The bill rate and what it includes, guaranteed hours, premium and call rates, travel and lodging terms, the credentialing timeline in business days, malpractice limits and who carries the tail, the replacement obligation when a provider leaves, the cancellation schedule by notice period, the invoice cadence and payment terms, and the conversion fee and how it is credited for hours worked.
- Does MedStaff Nationwide place locum tenens providers?
- Yes. MedStaff Locum Tenens is the interim coverage arm of MedStaff Nationwide, placing physicians, nurse practitioners, physician assistants, and CRNAs on written Work Orders with the credentialing file delivered in five business days and $1M/$3M malpractice included.