The quick answer
Registered nurses earned a national median of $97,550 in May 2025, according to the U.S. Bureau of Labor Statistics. The BLS industry breakdown for home health care services showed an annual mean wage of $87,430 for RNs in May 2023, the latest industry figure in this guide, with about 179,530 RNs employed in that industry. Licensed practical and vocational nurses earned a national median of $64,400 in May 2025.
Those national numbers hide wide variation. Location, experience, role and pay model all change what a home health nurse takes home. This guide breaks down each factor.
Home health nurse salary at a glance
Measure | Figure | Source period |
|---|---|---|
RN national median (all settings) | $97,550 | May 2025 |
RN 10th to 90th percentile range | $68,940 to $137,470 | May 2025 |
RN annual mean wage, home health care services | $87,430 | May 2023 |
LPN/LVN national median | $64,400 | May 2025 |
RN projected job growth | 6% from 2025 to 2035 | BLS projections |
The gap between the hospital and home health averages narrows or reverses for experienced nurses on productive per-visit pay plans, and widens for salaried nurses with heavy documentation loads. That is why it is worth understanding how home health pay works, not just the headline number.
Pay by location
Geography is the biggest single driver of nursing pay. These are BLS May 2025 RN medians for three markets where home health demand is high:
Area | RN median pay (May 2025) | Compared with national median |
|---|---|---|
United States | $97,550 | Baseline |
Riverside-San Bernardino-Ontario, CA metro (includes Palm Springs and the Coachella Valley) | $133,940 | About 37% higher |
New York-Newark-Jersey City metro | $119,720 | About 23% higher |
Houston-Pasadena-The Woodlands metro | $99,830 | About 2% higher |
California leads the country, with a statewide RN median above $140,000 in BLS May 2025 data. Higher pay usually tracks higher living costs, so compare offers against local housing and transportation costs before treating a bigger number as a raise.
Interestingly, Medicare's home health payments are also adjusted for local wages. The labor-related share of each payment, 74.9% in 2026, is multiplied by the area wage index. That helps agencies in high-wage markets afford higher nurse pay, though the adjustment rarely closes the gap completely.
Pay by role
Home health nursing role | What the job involves | Typical pay pattern |
|---|---|---|
Field RN (visit nurse) | Routine skilled visits, wound care, teaching, medication management | Per visit or hourly |
RN case manager | Start of care assessments, OASIS, care planning, coordination | Salary or salary plus productivity |
LPN/LVN | Skilled visits under RN supervision | Per visit or hourly |
Clinical manager or director of nursing | Supervision, survey readiness, quality and compliance | Salary |
OASIS or QA reviewer | Assessment accuracy and coding review, often remote | Salary or hourly |
Intake nurse | Referral review, eligibility and admission planning | Hourly or salary |
Nurse practitioner | Certifying or face-to-face visits for some organizations | Salary |
Case managers often earn more than field nurses because they carry responsibility for the OASIS, which affects both the agency's quality scores and Medicare payment under the Patient-Driven Groupings Model (PDGM).
How home health nurses are paid
Home health uses pay models that hospital nurses may not have seen before.
Per-visit pay. The nurse earns a set amount per visit. Start of care and recertification visits, which include the full OASIS assessment, usually pay more than routine visits. Resumption of care and discharge visits often have their own rates.
Hourly pay. Common for PRN nurses, intake roles and continuous-care cases.
Salary with productivity expectations. Many agencies pay case managers a salary with a target number of visits or productivity points per week. Some pay bonuses above target.
Mileage and drive time. Most agencies reimburse mileage. Some also pay for drive time, which can add up quickly in rural areas or congested cities.
Bonuses. Sign-on, referral, weekend and on-call pay are common, especially in tight labor markets.
When comparing offers, estimate real weekly earnings. Multiply your expected visits per week by the per-visit rate, add mileage, and subtract the unpaid time you will spend on documentation.
How to calculate your per-visit earnings
Here is a simple illustration. Suppose a nurse completes 25 routine visits a week at $55 per visit and two start of care visits at $120 each. That is $1,375 plus $240, or $1,615 a week before mileage. Over 50 weeks, that is roughly $80,750. A nurse doing 30 routine visits a week at the same rates earns about $94,500.
These are illustrative numbers, not market rates. The point is that productivity drives income under per-visit models, so documentation efficiency and route planning matter a lot.
Factors that raise home health nurse pay
Experience, especially in med-surg, cardiac, wound care or rehab.
Certifications, such as wound care (CWS or WOCN), OASIS specialist (COS-C) or home health coding (BCHH-C).
A BSN, which some agencies require for case manager or leadership roles.
Specialty programs, such as infusion, pediatrics, behavioral health or cardiac programs.
Leadership roles, including clinical manager or director of nursing.
Flexible availability, including weekends, on-call or PRN coverage.
How agency finances affect nurse pay
Nurse pay depends on agency revenue. Under the CY 2026 Home Health Prospective Payment System, the national standardized 30-day period payment is $2,038.22, slightly lower than in 2025 after CMS applied permanent and temporary behavioral adjustments. CMS has proposed raising the rate to $2,092.27 for 2027, but that rule was not final as of this writing.
When reimbursement is flat or falling, agencies have less room to raise wages. That makes revenue cycle performance a workforce issue. Agencies that lose money to late Notices of Admission, coding errors or slow A/R have less to invest in their nurses.
Many agencies address this by partnering with a specialized home health billing company. Clean claims and faster cash give leaders the predictability they need to offer competitive pay and bonuses. Agencies comparing home health billing in USA options often find that billing improvements fund retention programs.
Regional dynamics matter here too. In the Coachella Valley, agencies supported by home health billing services in Palm Springs compete for nurses in one of the highest-paying RN markets in the country. Agencies focused on home health billing in Houston work in a large market with pay close to the national median. And home health billing companies in NYC serve agencies that must balance high nurse wages with complex Medicaid and managed care billing.
Is home health nursing worth it?
For many nurses, yes. Home health offers one-to-one patient time, schedule flexibility and independence that hospital units rarely provide. The tradeoffs are driving, solo decision-making and documentation demands. Nurses who are organized and comfortable with technology tend to do well, and often earn more over time as their productivity grows.
How agencies can protect nurse time
Nurses lose pay, and agencies lose money, when clinicians spend hours fixing paperwork. Common culprits include OASIS corrections, missing visit note elements and unsigned orders that hold up billing. A strong home health billing service catches these issues early and routes them back with clear instructions, so nurses spend less time on rework and more on patients.
FAQs
How much does a home health RN make per hour? The national RN median in May 2025 was about $46.90 per hour across all settings. Home health hourly rates vary by market and pay model.
Do home health nurses make more than hospital nurses? On average, BLS data shows home health RNs earn somewhat less than hospital RNs, but productive per-visit nurses and case managers in high-wage markets can match or exceed hospital pay.
What is the highest-paying state for RNs? California, with a statewide median above $140,000 in May 2025 BLS data.
How much do home health LPNs make? The national LPN/LVN median was $64,400 in May 2025.
Sources: BLS Occupational Outlook Handbook: Registered Nurses; BLS OEWS May 2023: Registered Nurses industry data; BLS Occupational Outlook Handbook: Home Health and Personal Care Aides (LPN comparison); WageDex: RN pay, New York metro (BLS OEWS May 2025); WageDex: RN pay, Houston metro; WageDex: RN pay, Riverside metro; IHA CY 2026 HH PPS final rule summary.
