On a Home Health Contract, Is Drive Time Paid and How Is Mileage Reimbursed?

If you are paid by the hour and not exempt from overtime, federal rules count the drive from one patient's home to the next as hours worked, while the drive from your home to the first visit and back from the last is ordinary commuting. Mileage is separate: an agency can repay it tax-free at up to the IRS standard mileage rate under an accountable plan, but if it pays nothing, you generally cannot deduct those miles yourself as an employee.

By ProTherapy Staffing, published October 22, 2026.

Is driving between patients counted as work time?

For an employee the Fair Labor Standards Act covers, yes. The Labor Department’s rule on travel that is all in the day’s work says: “Time spent by an employee in travel as part of his principal activity, such as travel from job site to job site during the workday, must be counted as hours worked.” Its fact sheet on hours worked repeats the point: travel “from job site to job site during the workday, is work time and must be counted as hours worked.”

The first and last drives of the day are different. The same fact sheet says: “An employee who travels from home before the regular workday and returns to his/her home at the end of the workday is engaged in ordinary home to work travel, which is not work time.” On a home health day, that makes the drive to your first patient and home from your last a commute, and the drives in between part of your paid day. Over a week of visits spread across a county, those middle drives can add up to hours.

Does it matter if you are paid per visit instead of by the hour?

It can, because hours worked matter most when they add up to overtime, and some professionals are exempt from overtime. The Labor Department’s professional exemption fact sheet says that to qualify, “The employee must be compensated on a salary or fee basis (as defined in the regulations) at a rate not less than the standard salary level,” and the advanced knowledge the job requires must be “customarily acquired by a prolonged course of specialized intellectual instruction.”

Hourly pay is not a fee. The fee basis rule says “Payments based on the number of hours or days worked and not on the accomplishment of a given single task are not considered payments on a fee basis,” and that a fee is generally paid “for the kind of job that is unique rather than for a series of jobs repeated an indefinite number of times.” Whether a per-visit plan meets that definition is a question for the agency to answer in writing. Ask whether it classifies you as exempt or non-exempt, and whether drive time counts toward your paid hours.

How should mileage between visits be reimbursed?

Through what the IRS calls an accountable plan. Publication 463 says a car allowance counts as accounted for when “The allowance is similar in form to and not more than the federal rate” and you prove “the time (dates), place, and business purpose” of the trips to your employer. Paid that way, “the allowance won’t be included in box 1 of your Form W-2.” A mileage allowance above the federal rate puts the excess in your wages.

For a car, the federal rate is the IRS standard mileage rate. For business use in 2026 it is 72.5 cents a mile from January 1 to June 30, and 76 cents a mile from July 1 to December 31. An agency may pay less than that, so ask for the rate in cents, which drives it covers and how you submit the log. Keep your own record of each day’s visits, addresses and miles even when the agency uses an app.

If you want a home health offer with the pay basis, drive time and mileage written out before you sign, ask a ProTherapy recruiter: Find my next contract.

Can you deduct the miles an agency does not pay for?

Generally not, as an employee. Publication 463 says the cost of using your car as an employee “will no longer be allowed to be claimed as an unreimbursed employee travel expense as a miscellaneous itemized deduction,” with exceptions only for groups such as Armed Forces reservists, qualified performing artists and fee-basis government officials. A home health contract that pays no mileage leaves the cost of every visit-to-visit mile with you.

That makes mileage a real line in the offer. When you compare two home health contracts, multiply the miles you expect to drive each week by the standard rate, and treat a contract with no mileage as paying that much less.

What should you ask before you sign a home health contract?

The settings guide compares home health with the other settings, and the contracts guide covers the clauses that apply to every contract.

Frequently asked questions

Is drive time between home health visits paid?

For an employee covered by the Fair Labor Standards Act and not exempt from overtime, yes: the Labor Department counts travel from job site to job site during the workday as hours worked. The drive from home to the first visit and back from the last is ordinary home to work travel, which is not work time.

Is mileage reimbursement taxable?

Not when it is paid under an accountable plan at no more than the IRS standard mileage rate and you account for the dates, places and business purpose of the trips. An allowance above the federal rate puts the excess in your wages.

Can I deduct home health mileage my agency doesn't reimburse?

Generally not. IRS Publication 463 says employees can no longer claim the cost of using their car as an unreimbursed employee travel expense, apart from a few groups such as Armed Forces reservists.

Sources

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