Best States for Physician Assistants in 2026: New York Leads as High-Pay Coastal Markets Dominate

Across LaborCove’s 2026 data, the top 10 states for physician assistants show distinct combinations of salary levels, employment counts, and Geography Scores. Several top-ranked states have median salaries well above the national figure, while others in the same top 10 sit below it but have larger employment counts or higher Geography Scores. The rankings therefore reflect more than just pay level. New York leads the list with the highest LaborCove Geography Score and the largest employment count among the top 10, even though California and New Jersey report higher median salaries. At the same time, Texas and Pennsylvania illustrate that states can appear in the top 10 with median salaries below the national median, supported by their Geography Scores and employment counts rather than by pay alone.

For 2026, LaborCove’s national data for physician assistants shows a median annual salary of $135,880 and employment of 162,150. National projected employment growth for the occupation is 20.4%, indicating an expected expansion across the country as a whole rather than within any specific state. The state rankings in this article should therefore be read as geographic snapshots within that national picture. Each state’s median salary and employment count can be compared directly with the national benchmarks, but the 20.4% projected growth rate remains a national statistic and is not a projection for any individual state in the top 10.

New York holds the #1 spot in LaborCove’s 2026 state ranking for physician assistants, with a Geography Score of 83.63. It reports a median annual salary of $160,880, which is higher than the national median salary of $135,880. New York also has an employment count of 19,140 physician assistants, which is identified as the largest employment market in the supplied geographic data. Within the top 10 states, New York’s employment exceeds that of California, Texas, and Pennsylvania, which have employment counts of 13,600, 10,110, and 9,020 respectively, while still maintaining a median salary above the national level.

California, New Jersey, Washington, and Hawaii each report median salaries above both the national median and New York’s median salary, yet they rank below New York in LaborCove’s Geography Scores. California ranks #2 with a Geography Score of 78.62, a median salary of $165,650, and employment of 13,600 physician assistants. New Jersey ranks #3 with a Geography Score of 62.28, a median salary of $165,690, and employment of 4,790. Washington holds the #4 ranking with a Geography Score of 59.18, a median salary of $164,360, and employment of 3,540. Hawaii ranks #5, with a Geography Score of 52.88, a median salary of $164,050, and employment of 530. These states illustrate that a higher median salary than New York does not automatically translate into a higher overall LaborCove ranking, underscoring that the Geography Score reflects more than salary alone.

Several states in the top 10 combine Geographic Scores with median salaries that exceed the national median of $135,880 for physician assistants. In addition to New York at $160,880, California at $165,650, New Jersey at $165,690, Washington at $164,360, Hawaii at $164,050, Massachusetts at $142,410, Oregon at $155,780, and New Hampshire at $150,960 all report median salaries above the national benchmark. Within this group, California and New Jersey have the highest supplied median salaries at $165,650 and $165,690, respectively. Oregon and New Hampshire, ranked #8 and #9, each have median salaries above the national figure even though they sit lower in the top 10 by Geography Score and have smaller employment counts than New York and California.

Two of LaborCove’s top 10 states for physician assistants have median annual salaries below the national median of $135,880. Texas, ranked #6 with a Geography Score of 52.15, reports a median salary of $134,550. Pennsylvania, ranked #10 with a Geography Score of 45.82, reports a median salary of $127,070. Both Texas and Pennsylvania have relatively large employment counts within the top 10. Texas has 10,110 employed physician assistants, while Pennsylvania has 9,020. In the top 10, Texas and Pennsylvania are the only states where the supplied median salary is below the national median, showing that top-10 Geography Scores can coincide with either above- or below-national pay levels.

LaborCove’s Best States rankings for physician assistants are based on structured labor-market data and the proprietary LaborCove Geography Score. For each state in this analysis, LaborCove uses the supplied median annual salary, employment count, and Geography Score to generate a comparative ranking. The national figures for median salary, employment, and projected employment growth describe the occupation overall and are not state-level growth rates. The national projected employment growth rate of 20.4% applies only to physician assistants across the country as a whole. Because individual circumstances differ, these rankings should be considered alongside personal and professional priorities. LaborCove’s Geography Scores and ranks summarize the supplied data, but they are not predictions about any specific physician assistant’s likelihood of finding work or advancing in a particular state.