What it means to work as a 1099 independent contractor on locum tenens assignments, and the questions worth asking before you sign.
Many locum tenens providers are engaged as 1099 independent contractors rather than W-2 employees. The name refers to the IRS Form 1099-NEC that is typically used to report payments to independent contractors, and the distinction affects how you are paid, how taxes are handled, and what benefits are or are not included.
As a W-2 employee, an employer withholds income and payroll taxes from each paycheck and often provides benefits such as health insurance or paid time off. As a 1099 independent contractor, you are generally treated as self-employed. That usually means taxes are not withheld for you, and you are responsible for setting aside and paying your own taxes, often through estimated quarterly payments.
Because self-employment carries additional tax responsibilities, many independent contractors work with a tax professional to understand estimated payments, deductions they may qualify for, and record-keeping expectations. Tax rules change and depend on your individual situation, so treat this as general background and confirm specifics with a qualified accountant or tax advisor rather than relying on general information.
The 1099 model can offer flexibility and autonomy, but it also shifts responsibility onto the provider. It is worth clarifying up front what is and is not included in an assignment, such as malpractice coverage, licensing or credentialing support, and any reimbursement for travel or lodging, since these vary by staffing agreement and facility.
Before accepting an assignment, ask your recruiter to confirm your classification in writing, along with the pay structure and anything the agency covers on your behalf. A transparent staffing partner should be able to walk you through these details clearly so there are no surprises at tax time or on your first day.