What should a home health agency look for in T&E software?
In home care the miles between patients, the records behind a Medicare cost report and what may reach a patient set the policy. Five things matter.
| What you need | Why | In ExpenseOS |
|---|---|---|
| Mileage at the rate in force | For non-exempt staff, travel from job site to job site during the workday is hours worked (29 CFR 785.38), and the IRS business rate was 72.5¢ a mile from January to June 2026 and 76¢ from 1 July (IRS Announcement 2026-11). | Mileage is worked out from the addresses at your agency's rate, and paid back the minute it clears. |
| Records an auditor can follow | A Medicare-certified agency files a cost report every year, from records capable of verification by qualified auditors and in sufficient detail to support payments (42 CFR 413.20 and 413.24). | Every expense keeps its receipt, GL code and cost center, with the rule it was checked against. |
| Miles paid back fast | Aides drive their own cars from visit to visit. Turnover for home care aides at home health agencies was 34.17% in 2025, down from 36.31% in 2024 (Hospital & Healthcare Compensation Service, 1,111 agencies). | Mileage and other expenses are paid back the minute they clear. |
| Nothing improper to patients or referral sources | The Inspector General treats items worth no more than $15 each and $75 a year to a Medicare or Medicaid patient, never cash, as nominal value (HHS Inspector General, 2016), and the Anti-Kickback Statute sets no dollar floor for referral sources. | The pack caps comfort items at $15 an item and sends nothing to referral sources, and every request is answered against it with the rule named. |
| Patient details kept out | A vendor that holds patient data for an agency is a business associate, allowed only with a written agreement (45 CFR 164.308(b)). | The pack codes supplies to the visit or to routine stock, never to a patient, and software that touches patient data gets a security review first. |
The rules that apply to home health and home care
What each rule requires, and what it means for a travel and expense policy.
| Rule | What it requires | What it means for your policy |
|---|---|---|
| IRS business mileage rate, 2026 | 72.5¢ a mile from 1 January to 30 June 2026, and 76¢ a mile from 1 July 2026 (Announcement 2026-11), raised midyear for fuel costs. | Use the rate in force on the day of each drive. |
| Travel between patients, 29 CFR 785.38 | 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. | For non-exempt staff, driving between visits is paid time. |
| Home to work travel, 29 CFR 785.35 | An employee who travels from home before the regular workday and returns home at the end of it is engaged in ordinary home to work travel, whether at a fixed location or at different job sites. Normal travel from home to work is not worktime. | The first drive of the day and the drive home are commute, unless your agency pays them. |
| Accountable plans, Treas. Reg. §1.62-2 | Reimbursements are tax-free when expenses are accounted for within a reasonable period (60 days is the safe harbor) and excess advances come back (120 days). Otherwise they are wages. | Set a submission deadline inside 60 days. |
| Cost data and cost reports, 42 CFR 413.20 and 413.24 | Providers keep financial records and statistical data sufficient to determine their costs and file a cost report every year, from records capable of verification by qualified auditors, accurate and in sufficient detail to support payments. CMS's home health cost report instructions apply both to every agency in Medicare. | Keep every expense's receipt and coding, so the books behind the cost report can be audited. |
| Gifts of nominal value, HHS Inspector General (2016) | The Inspector General treats a gift to a Medicare or Medicaid beneficiary as nominal value when it's worth no more than $15 an item or $75 a patient a year in the aggregate, and never cash or cash equivalents. | Cap comfort items at $15 an item and $75 a patient a year. |
| Anti-Kickback Statute, 42 U.S.C. 1320a-7b(b) | Knowingly and willfully offering or paying any remuneration, in cash or in kind, to induce referrals of federal health care program business is a felony. The statute sets no dollar floor. | Nothing of value to a referral source. |
| HIPAA business associates, 45 CFR 164.308(b) | A covered entity may permit a business associate to create, receive, maintain or transmit electronic protected health information on its behalf only with satisfactory assurances, in a written contract or other arrangement. | Software that touches patient data needs a signed business associate agreement before anyone buys it. |
| Home health aide training, 42 CFR 484.80 | Home health aides complete at least 75 hours of training, and at least 12 hours of in-service training in each 12-month period. | Budget each year for renewals and in-service training. |
| Meals, entertainment and gifts, IRC §274 | Business meals are 50% deductible when they aren't lavish and an employee is there; entertainment isn't deductible; business gifts are deductible up to $25 a recipient a year. | Log who was at a business meal and why, and keep entertainment and gifts apart from meals. |
| GSA per diem rates, FY2027 | From 1 October 2026: $113 a night for lodging and $68 a day for meals and incidentals in most of the continental US, with higher rates in 295 areas and meal rates from $68 to $92. | The federal rate for the destination sets the tax-free ceiling, and the limit on federally billed travel. |
2026 market benchmarks for home health and home care
Published figures to measure a travel and expense policy against.
| Benchmark | Figure | Source |
|---|---|---|
| IRS business mileage, from 1 Jul 2026 | 76¢ a mile (72.5¢ before) | IRS Announcement 2026-11 |
| Home care aide turnover at home health agencies, 2025 | 34.17%, down from 36.31% in 2024 | Hospital & Healthcare Compensation Service, via LeadingAge |
| Medicare's average non-routine supply cost, 2024 | $4.89 a visit | CMS, CY2027 home health proposed rule |
| Gifts to Medicare and Medicaid patients | $15 an item, $75 a year | HHS Office of Inspector General |
| Federal per diem, FY2027 standard | $113 lodging, $68 meals and incidentals | GSA |
| California RN license renewal | $190 every 2 years | California Board of Registered Nursing |
| National home care conference, 2026 | $1,725 a member, $2,125 a non-member | Home Care Association of America |
The home health and home care policy pack
On day one, a company starts from the pack for its industry. This one is for home health, home care and hospice agencies whose aides and nurses drive from visit to visit: mileage at the IRS rate, supplies coded to the visit, and no patient details on any expense. Each category starts with a limit and a rule.
Mileage between visitsIRS rate76¢ a mile since 1 July 2026, for the date of each drive, logged from the route. The first and last drives of the day are commute unless your agency says otherwise, and your own car never claims fuel. Reimbursement lands in about a minute once it clears.
Patient-care suppliesSet by your agencyAgency stock first. On your own card, the itemized receipt, coded to the visit or to routine stock, never a patient's name. CMS's average non-routine supply cost was $4.89 a visit in 2024.
Medical equipmentApproved firstAgency property: approved before you buy, tagged, and cleaned between patients. Equipment for a patient's own use goes through the agency's ordering.
Certifications and training$750 a person a yearLicense renewals, required in-service training and CPR or BLS courses, paid on time. Training time is paid as work, and no one repays required training.
Patient comfort items$15 an itemNever cash or a gift card. The $75 a patient a year is your agency's to track, and no patient's name goes on the expense.
Training and conference travel$900 a round tripEconomy at the lowest logical fare, 7 days ahead when you can, with registration at the member rate.
LodgingMarket rateRare overnights: each city's market rate this week with no margin above it, or $175 a night where there's no market data. The conference block is fine, and the itemized hotel bill for every stay.- Meals$68 a dayWhat you spend on nights away, up to the federal standard meals rate, with receipts at $25. No alcohol.
Gifts$25 a person a yearThe most that's tax-deductible. Name who gets it, and nothing to a referral source.
Software$500 a monthScheduling and visit-verification tools are agency contracts. A manager approves any charge over $1,000, and anything that touches patient data needs a security review and a business associate agreement first.
Every line is a starting point. Admins change limits on screen or in a sentence, and ExpenseOS shows every change it would make before anything applies. From then on, every request is answered against the policy before the money moves, with the rule named, and anything out of policy goes to a person with the reason.
Questions home health and home care agencies ask
What should a home health agency look for in T&E software?
Mileage paid at the IRS rate for every drive between visits, records an auditor can follow behind the cost report, limits on what reaches a patient or a referral source, and no patient details on expenses. ExpenseOS starts agencies from a policy pack built for that and answers every request before the money moves, with the rule named.
What is the IRS mileage rate for home health aides in 2026?
72.5¢ a mile for business driving from 1 January to 30 June 2026, and 76¢ a mile from 1 July 2026 (IRS Announcement 2026-11). Use the rate in force on the day of each drive. Federal wage law doesn't require the IRS rate, but a non-exempt worker's unreimbursed car costs can't take the week's pay below the minimum wage, and the Labor Department may value them at the IRS rate (29 CFR 531.35; Field Operations Handbook 30c15).
Is driving between patients paid work time?
For non-exempt staff, yes: travel from job site to job site during the workday is hours worked (29 CFR 785.38). The drive from home to the first patient and back home at the end of the day is ordinary commuting (29 CFR 785.35). Paying the miles at the IRS rate under an accountable plan keeps the reimbursement tax-free (Treas. Reg. 1.62-2).
What records does Medicare expect behind an agency's expenses?
A Medicare-certified agency files a cost report every year, and the cost data behind it must be capable of verification by qualified auditors, accurate and in sufficient detail to support payments (42 CFR 413.20 and 413.24). ExpenseOS keeps each expense's receipt, GL code and cost center; it doesn't prepare cost reports.
Can staff buy small gifts for patients?
Small ones. The Inspector General treats items worth no more than $15 each and $75 a year to a patient, never cash or cash equivalents, as nominal value (HHS Inspector General, 2016), and the pack keeps comfort items to $15 an item. Gifts to referral sources are a different matter: the Anti-Kickback Statute sets no dollar floor, so the pack sends them nothing.
Does the home health pack hold patient information?
It's built to keep it out: supplies are coded to the visit or to routine stock, never to a patient, and no patient's name goes on an expense. Software that touches patient data needs a security review and a signed business associate agreement first (45 CFR 164.308(b)).
Related
Start from the home health and home care pack.
A short walkthrough mapped to your policy: what the pack sets up, what you would change, and how every request is answered before the money moves.
Sources
- IRS business mileage rate, 2026
- Travel between patients, 29 CFR 785.38
- Home to work travel, 29 CFR 785.35
- Accountable plans, Treas. Reg. §1.62-2
- Cost data and cost reports, 42 CFR 413.20 and 413.24
- Gifts of nominal value, HHS Inspector General (2016)
- Anti-Kickback Statute, 42 U.S.C. 1320a-7b(b)
- HIPAA business associates, 45 CFR 164.308(b)
- Home health aide training, 42 CFR 484.80
- Meals, entertainment and gifts, IRC §274
- GSA per diem rates, FY2027
- Hospital & Healthcare Compensation Service, via LeadingAge
- CMS, CY2027 home health proposed rule
- California Board of Registered Nursing
- Home Care Association of America
Rules and figures as published on 3 November 2026. This page summarizes public rules and published figures for general information; it is not legal or tax advice.