Navy Medicine's FY27 Special Pay Changes: RAM Bonuses Rise to $70,000 on a New 6-Year Contract, and Three Corps Get Bonuses They Did Not Have
BUMED's FY27 Summary of Changes raises the Aerospace Medicine retention bonus at every contract length and adds a six-year agreement at $70,000 a year, lifts the Preventive/Occupational Medicine three-year bonus from $23,000 to $30,000, and creates retention bonuses for NICU nurses, Medical Laboratory officers and nurses entering CRNA, FNP or MHNP training. Requests back to October 1, 2026 are open until November 20, 2026. The statute behind every agreement expires December 31, 2026 unless Congress extends it.
The bottom line up front
- 1.The FY27 Summary of Changes, posted with NAVADMIN 233/26 (October 5, 2026), raises the Aerospace Medicine retention bonus to $25,000, $35,000 and $50,000 on two-, three- and four-year contracts and creates a six-year contract at $70,000; FY26 topped out at $45,000.
- 2.The Preventive/Occupational Medicine three-year retention bonus rises from $23,000 to $30,000. Critical Care and Pulmonary Medicine become separate specialties at the same rates. Three increases stack on a clinical specialty: $3,000 for UMO, $3,000 for Navy Flight Surgeon, $5,000 for RAM-trained specialists in a RAM billet.
- 3.New bonuses: Medical Laboratory officers at LCDR/CDR with 12 to 22 years commissioned service can take $5,000, $10,000 or $15,000 a year on 3-, 4- or 6-year contracts; NICU nurses get a retention bonus of $10,000 to $20,000 a year; nurses entering CRNA, FNP or MHNP DUINS get $10,000 a year.
- 4.Incentive pay, Board Certification Pay ($8,000) and every accession bonus are unchanged from FY26. Requests effective October 1, 2026 must be in by November 20, 2026; other requests NET 60 days before and NLT 30 days after the effective date.
- 5.37 U.S.C. 335(k) bars new agreements after December 31, 2026. H.R. 8800 and S. 4784 both extend it to 2027; the House passed its bill July 22, the Senate cloture vote failed July 14, and CRS reports the FY2027 NDAA not enacted as of September 1, 2026.
Navy Medicine's FY27 Special Pay Summary of Changes, a two-page document on the Bureau of Medicine and Surgery's Special Pays page, raises the Aerospace Medicine retention bonus at every contract length and adds a six-year agreement at $70,000 a year; the FY26 guidance topped out at $45,000 on a four-year contract. It lifts the Preventive/Occupational Medicine three-year bonus from $23,000 to $30,000, splits Critical Care and Pulmonary Medicine into two rows, and creates three bonuses that did not exist last year: a retention bonus for NICU nurses, one for Medical Laboratory officers at LCDR and CDR, and a $10,000 bonus for nurses entering CRNA, FNP or MHNP training. That much is settled. NAVADMIN 233/26, released October 5, 2026, opened FY27 requests, all four corps guidance PDFs are posted, and BUMED's page note dated October 20, 2026 gives members until November 20, 2026 to submit a request effective back to October 1, 2026. What is not settled is the law underneath. 37 U.S.C. 335(k) says "no agreement may be entered into under this section after December 31, 2026," and the one-year extension sits in two NDAA bills that have not passed.
The authority for every one of these agreements expires December 31, 2026 unless Congress acts
Section 611(d)(4) of S. 4784 and section 601(d)(4) of H.R. 8800 each strike "December 31, 2026" from 37 U.S.C. 335(k) and insert "December 31, 2027." The House passed H.R. 8800 on July 22, 2026, 216 to 212. Cloture on the motion to proceed to S. 4784 failed 50 to 46 on July 14, 2026, and the Congressional Research Service's September 1, 2026 status report says the FY2027 NDAA "has not been enacted." Last year's extension came in Public Law 119-60, signed December 18, 2025, thirteen days before the deadline. An agreement already accepted is protected by the guidance's own words: "Upon acceptance by the Chief, BUMED, the total amount paid under the agreement shall be fixed during the length of the agreement." The exposure is on agreements not yet signed if the date passes, as it did on December 31, 2007; our Navy SRB guide covers that lapse.
What moved from FY26 to FY27, line by line
The Summary of Changes says every FY27 change "is highlighted in yellow on the respective Corps Pay Guidance." The table puts the FY26 and FY27 Medical Corps guidance side by side, with the Dental, Medical Service and Nurse Corps items from their own FY27 PDFs. Retention bonus (RB) figures are per year of the contract, paid "in lump sum annually on the anniversary date of the contract." Incentive pay (IP) is an annual rate paid monthly.
| Change | FY26 guidance | FY27 guidance |
|---|---|---|
| Aerospace Medicine (RAM) RB, 2-year | $20,000 | $25,000 |
| RAM RB, 3-year | $30,000 | $35,000 |
| RAM RB, 4-year | $45,000 | $50,000 |
| RAM RB, 6-year | Not offered | $70,000 |
| Preventive/Occupational Medicine RB, 3-year | $23,000 | $30,000 ("the HA authorized rate") |
| Critical Care and Pulmonary Medicine | One row, Pulmonary/Critical Care (Adult/Pediatric) | Two rows, same rates: IP $60,000; RB $27,000, $37,000, $63,000, $78,000. Adult and pediatric physicians may qualify for either |
| Navy Flight Surgeon increase for clinical specialists (footnote 6) | None | $3,000 above the clinical specialty IP and RB; at least 40 hours a year of aviation medicine |
| RAM-trained clinical specialist increase (footnote 7) | None | $5,000 above the clinical specialty IP and RB; must be assigned to a RAM billet for the whole agreement |
| Undersea Medical Officer increase (footnote 5) | $3,000 "on a case-by-case basis, verified by the Medical Corps Chief" | $3,000 with UMO privileges, an OPPE on file, and at least 70 undersea medical encounters a fiscal year |
| Physicians in fellowship | Not stated | "eligible for the general specialty IP while attending fellowship" |
| Declining an accession bonus | Not stated | Not eligible for an RB "until completion of their initial Minimum Service Requirement" |
| Board Certification Pay eligibility | Certified, licensed | Certified, licensed, "privileged, and practicing the specialty for which the BCP is being paid" |
| Dental Corps BCP boards | Existing list | Adds the American Certifying Board of Oral Maxillofacial Radiology |
| Medical Service Corps, Medical Laboratory officers (LCDR/CDR, 12 to 22 years commissioned service as of October 1, 2026) | No RB | RB $5,000 (3-year), $10,000 (4-year), $15,000 (6-year) |
| Nurse Corps, Neonatal Intensive Care (1964, "K" suffix with tertiary "V") | No RB | RB $10,000 to $20,000 a year on two- to four-year agreements; may enter NICU DUINS and keep the bonus |
| Nurse Corps, General/Clinical Nurse DUINS (CRNA/FNP/MHNP) | No RB | $10,000 a year, effective the day before DUINS starts; a specialty RB may be terminated and renegotiated into it |
What did not move
Every Medical Corps incentive pay rate is the FY26 figure: $1,200 for internship, $8,000 for initial residency, $20,000 for a General Medical Officer and $25,000 for a GMO serving as an Aviation or Undersea Medical Officer, then $43,000 for Family Medicine, Internal Medicine, Pediatrics, Preventive Medicine and RAM, $66,000 for Anesthesiology, General Surgery, Orthopedics and Radiology, and $75,000 for Neurosurgery. Board Certification Pay stays at $8,000 a year in all four corps. The accession bonus table is unchanged: $225,000 for three years or $400,000 for four in any physician specialty, and the Critically Short Wartime Specialty Accession Bonus up to $450,000 on three years and $800,000 on four for Cardio-Thoracic, Trauma/Critical Care and Vascular Surgery. The large retention bonuses are flat too: General Surgery, Orthopedics and Anesthesiology keep $105,000 on four years and $125,000 on six, Neurosurgery $150,000 on both. Our special pay rates page covers the DFAS-wide pays; the medical department figures live only in these PDFs.
What the FY27 package is worth against basic pay, by grade
Medical department officers draw the same basic pay table as every other officer, and the bonuses sit on top of it. The table takes 2026 monthly basic pay from our DFAS data, multiplies by 12, and adds the FY27 retention bonus, incentive pay and Board Certification Pay for one specialty at each grade. The last column is the special pay package as a share of annual basic pay. Run your own grade and years through the basic pay calculator and the 2027 military pay chart for the January raise that is still pending in the same NDAA.
Grade and years
| Grade and years | 2026 basic pay, monthly | Basic pay, annual | FY27 specialty and contract | RB + IP + BCP per year | Special pay as share of basic pay |
|---|---|---|---|---|---|
| O-3 over 4 | $7,382.70 | $88,592.40 | GMO serving as Undersea or Aviation Medical Officer, IP only | $25,000 | 28% |
| O-3 over 6 | $7,737.00 | $92,844.00 | Family Medicine, 4-year RB | $48,000 + $43,000 + $8,000 = $99,000 | 107% |
| O-4 over 8 | $8,816.40 | $105,796.80 | Aerospace Medicine, new 6-year RB | $70,000 + $43,000 + $8,000 = $121,000 | 114% |
| O-4 over 12 | $9,888.30 | $118,659.60 | Preventive/Occupational Medicine, 3-year RB | $30,000 + $43,000 + $8,000 = $81,000 | 68% |
| O-5 over 14 | $10,715.10 | $128,581.20 | General Surgery, 6-year RB | $125,000 + $66,000 + $8,000 = $199,000 | 155% |
| O-5 over 18 | $11,713.80 | $140,565.60 | Nurse Corps CRNA, 6-year RB | $75,000 + $18,000 + $8,000 = $101,000 | 72% |
| O-6 over 22 | $14,112.90 | $169,354.80 | Anesthesiology, 6-year RB | $125,000 + $66,000 + $8,000 = $199,000 | 118% |
Two things to read off the table. For a RAM physician the six-year contract is the whole story: $70,000 a year against $45,000 on the best FY26 contract, and $420,000 over the agreement. And none of it moves retired pay. 10 U.S.C. 1407 computes the retired pay base from monthly basic pay alone, so the High-3 calculator result is the same with or without the bonus. IP and BCP arrive monthly and "reflect on the LES as SAVED PAY," in the guidance's words, while the RB is a lump sum each anniversary.
Worked example
An O-4 over 10 in Aerospace Medicine, board certified, signs the new 6-year RB on November 1, 2026
Under the FY26 guidance the same physician's best option was the 4-year RB at $45,000, so the FY27 contract adds $25,000 in each of the first four years and keeps paying $70,000 in years five and six: $420,000 over the agreement against $180,000. The guidance's own example says a member who entered a 4-year RB/IP on July 1, 2026 "is eligible to terminate and renegotiate for a 6 year RB/IP as early as 1 October 2026, provided the specialty is eligible," which RAM now is. Basic pay here is the 2026 rate; the 2027 raise is not law.
How and when to submit
BUMED's page note, dated October 20, 2026, sets two clocks. For a request effective back to October 1, 2026, members "will have until 20 Nov 2026" to submit. For every other FY27 request, the window under OPNAVINST 7220.17 is "NET 60 days prior to the effective date, and NLT 30 days after the effective date." Medical Corps officers asking for the new UMO, Flight Surgeon or RAM increase on top of a clinical specialty use the IP or RB/IP templates posted under Templates on the same page, with the matching checklist. Requests go through the command's HRD or admin office.
- A retention bonus needs a signed agreement accepted by Chief, BUMED. The member submits the request with a Commanding Officer endorsement, BUMED prepares the agreement, and the member returns an acceptance or declination letter. The RB obligation runs concurrently with IP, BCP, promotion and BRS continuation pay obligations.
- Renegotiating into a longer contract requires at least one more year. A new agreement must extend the obligation "at least one year beyond the current RB obligation," at the rate in effect when the new contract is executed, and never covers time already served under the old one.
- Only one Board Certification Pay is paid regardless of how many certifications an officer holds, and from FY27 the officer must be practicing the certified specialty to draw it.
The statute and its ceilings
All of this is paid under 37 U.S.C. 335, "Special bonus and incentive pay authorities for officers in health professions," implemented by Department of War Instruction 6000.13 and OPNAVINST 7220.17, the three references NAVADMIN 233/26 lists. The statute caps a retention bonus at $150,000 per twelve-month period, incentive pay at $200,000 a year for medical and dental officers and $50,000 for other health professions, and Board Certification Pay at $15,000. The highest Navy retention bonus, Neurosurgery at $150,000, sits exactly at that ceiling. The same section's subsection (k) carries the December 31, 2026 date, which Public Law 119-60 moved there from December 31, 2025 last December.
The bottom line
The FY27 plan moves money in three places: Aerospace Medicine, where the new six-year contract is worth $70,000 a year and every shorter contract is up $5,000; Preventive/Occupational Medicine, where the three-year bonus rises $7,000; and three new bonuses for NICU nurses, Medical Laboratory officers and nurses headed into CRNA, FNP or MHNP training. Everything else, from the $43,000 primary care incentive pay to the $800,000 surgical accession bonus, is the FY26 figure. Requests effective October 1, 2026 close November 20, 2026, and the authority to sign anything closes December 31, 2026 unless the NDAA passes first. Bonus figures are FY27 Navy rates and basic pay is the 2026 DFAS table; always verify with your HRD, your command's finance office, or BUMED Special Pays before making financial decisions.
Sources
- Navy Bureau of Medicine and Surgery, "FY27 Special Pay Summary of Changes" (2 pages, file dated October 7, 2026): all corps, accession bonus declination rule and BCP "licensed, privileged, and practicing"; Medical Corps fellowship clarification, "Increases RAM 2, 3, 4 RB rates, and creates a 6 year RB," Critical Care and Pulmonary separated, Preventive/Occupational Medicine 3-year RB "to the HA authorized rate," footnotes 5, 6 ($3,000 NFS) and 7 ($5,000 RAM); Dental Corps American Certifying Board of Oral Maxillofacial Radiology; Medical Service Corps Medical Laboratory Officer LCDR/CDR 12 to 22 years 3-, 4- or 6-year RB; Nurse Corps NICU "K" suffix RB and CRNA/FNP/MHNP DUINS RB $10,000 (https://www.med.navy.mil/Portals/62/Documents/BUMED/Special%20Pays/FY27/FY27%20SPECIAL%20PAY%20SUMMARY%20OF%20CHANGES.pdf)
- BUMED, "FY27 Navy Active Component Medical Corps Special Pay Guidance" (14 pages, file dated October 7, 2026), Table 1 accession bonuses (HPO AB $225,000 / $400,000; CSWSAB $281,250 to $450,000 / $500,000 to $800,000), Table 2 IP and RB (RAM $43,000 IP, RB $25,000 / $35,000 / $50,000 / $70,000; Preventive/Occupational Medicine RB $15,000 / $30,000 / $35,000 / $40,000; Critical Care and Pulmonary each $60,000 IP, RB $27,000 / $37,000 / $63,000 / $78,000; General Surgery, Orthopedics, Anesthesiology $66,000 IP, RB $105,000 4-year and $125,000 6-year; Neurosurgery $75,000 IP, RB $150,000), Table 3 BCP $8,000, footnotes 5 to 7, paragraphs 1d, 3c (renegotiation example), 3e, 4b, 5a ("SAVED PAY"; "the total amount paid under the agreement shall be fixed") (https://www.med.navy.mil/Portals/62/Documents/BUMED/Special%20Pays/FY27/FY27%20MC%20SPECIAL%20PAY%20GUIDANCE.pdf)
- BUMED, "FY26 Navy Active Component Medical Corps Special Pay Guidance" (14 pages, file dated November 19, 2025), Table 2: RAM RB $20,000 / $30,000 / $45,000 with no 6-year rate; Preventive/Occupational Medicine RB $15,000 / $23,000 / $35,000 / $40,000; single row Pulmonary/Critical Care (Adult/Pediatric); footnote 5 UMO $3,000 "on a case-by-case basis, verified by the Medical Corps Chief"; identical IP, BCP and accession bonus figures (https://www.med.navy.mil/Portals/62/Documents/BUMED/Special%20Pays/FY26/FY26%20MC%20SPECIAL%20PAY%20GUIDANCE.pdf)
- BUMED, "FY27 Navy Active Duty Nurse Corps Special Pays Guidance" (15 pages, file dated October 7, 2026): paragraph 3a(3)(a) NICU (1964) nurses who enter DUINS retain the full specialty bonus; 3a(3)(c) and 3c(3) termination and renegotiation into the General/Clinical Nurse DUINS (CRNA/FNP/MHNP) RB; 3a(5) "K" suffix with tertiary "V"; Table 2 Neonatal Intensive Care $10,000, $15,000, $20,000 with no 6-year rate, CRNA IP $18,000 and RB $20,000 / $30,000 / $50,000 / $75,000, General/Clinical Nurse DUINS (CRNA/FNP/MHNP) $10,000; Table 5 BCP $8,000 (https://www.med.navy.mil/Portals/62/Documents/BUMED/Special%20Pays/FY27/FY27%20NC%20SPECIAL%20PAYS%20GUIDANCE.pdf)
- BUMED, "FY27 Medical Service Corps Special Pay Guidance" (12 pages, file dated October 7, 2026), Table 2: Medical Laboratory RB $5,000 3-year, $10,000 4-year, $15,000 6-year, with a footnote limiting it to Medical Laboratory officers LCDR/O4 and CDR/O5 between 12 and 22 years commissioned service "as of 1 October 2026"; Table 3 BCP $8,000 (https://www.med.navy.mil/Portals/62/Documents/BUMED/Special%20Pays/FY27/FY27%20MSC%20SPECIAL%20PAY%20GUIDANCE.pdf)
- Navy Medicine, Special Pays page, note dated 20 Oct 2026: "The FY27 Special Pays NAVADMIN (233/26) has been released. Requests can be submitted for FY27, which members will have until 20 Nov 2026 to be able to submit a request back to 1 Oct 26, if eligible"; other requests "IAW OPNAVSINT 7220.17 NET 60 days prior to the effective date, and NLT 30 days after the effective date"; Summary of Changes and FY27 corps guidance links; UMO, Flight Surgeon and RAM increase templates (https://www.med.navy.mil/Special-Pays/)
- NAVADMIN 233/26, R 051645Z OCT 26, "FY-27 Medical Department Officer Special Pays for Active Duty": references 37 U.S.C. 335, Department of War Instruction 6000.13 and OPNAVINST 7220.17; "Submission of requests for fiscal year (FY) 2027 special and incentive pays may begin upon release of this NAVADMIN"; corps-specific guidance at med.navy.mil/Special-Pays (https://www.mynavyhr.navy.mil/Portals/55/Messages/NAVADMIN/NAV2026/NAV26233.pdf)
- 37 U.S.C. 335, Special bonus and incentive pay authorities for officers in health professions: (a)(3) retention agreements, (e)(1) bonus caps of $100,000, $200,000 and $150,000 per 12-month period, (b) incentive pay cap $200,000 for medical and dental officers and $50,000 for other health professions, (c) board certification pay cap $15,000, (k) "No agreement may be entered into under this section after December 31, 2026" as amended by Pub. L. 119-60 (https://www.law.cornell.edu/uscode/text/37/335)
- Public Law 119-60, National Defense Authorization Act for Fiscal Year 2026, approved December 18, 2025, section 611(d)(4): 37 U.S.C. 335(k) amended by striking "December 31, 2025" and inserting "December 31, 2026" (reference-docs/bonus-authority-sunset-37usc331-ndaa-extracts-2026-10-08.txt) (https://www.govinfo.gov/content/pkg/PLAW-119publ60/html/PLAW-119publ60.htm)
- H.R. 8800, engrossed in the House July 22, 2026, section 601(d)(4), and S. 4784, reported in the Senate June 15, 2026 (S. Rept. 119-127), section 611(d)(4): each strikes "December 31, 2026" and inserts "December 31, 2027" in 37 U.S.C. 335(k) (https://www.govinfo.gov/content/pkg/BILLS-119hr8800eh/html/BILLS-119hr8800eh.htm) (https://www.govinfo.gov/content/pkg/BILLS-119s4784rs/html/BILLS-119s4784rs.htm)
- Congressional Research Service, IN12704, "FY2027 NDAA: Status of Legislative Activity," September 1, 2026: House passed H.R. 8800 as amended July 22, 216-212; SASC reported S. 4784 June 15; cloture on the motion to proceed failed 50-46 July 14; "The FY2027 NDAA has not been enacted" (https://www.everycrsreport.com/reports/IN12704.html)
- 10 U.S.C. 1407(c)(1), high-three average: "the total amount of monthly basic pay to which the member was entitled for the 36 months" (https://www.law.cornell.edu/uscode/text/10/1407)
- DFAS 2026 basic pay tables, effective January 1, 2026 (server/data/base-pay-2026.json): O-3 over 4 $7,382.70, O-3 over 6 $7,737.00, O-4 over 8 $8,816.40, O-4 over 10 $9,420.00, O-4 over 12 $9,888.30, O-5 over 14 $10,715.10, O-5 over 18 $11,713.80, O-6 over 22 $14,112.90 (https://www.dfas.mil/MilitaryMembers/payentitlements/Pay-Tables/)
Figures reflect 2026 rates and regulations. This guide is general information, not personalized financial or tax advice. Always verify with your finance office or a tax professional before making a decision. How we research and source: our methodology.
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REF: Military Toolkit Guides, effective 2026
Official 2026 DoD, DFAS, DTMO, IRS, and VA sources. See each guide’s Sources list
Results are estimates. Always verify with your finance office.
Reviewed by Guilherme Correia · Military Toolkit editorial