The average home health nurse earns between $87,000 and $91,000 per year in base salary according to aggregated 2025–2026 data – a range that now sits slightly below the national RN median of $97,550 (BLS OEWS, May 2025) rather than above it – the May 2025 rollover raised the all-RN median faster than home health agency pay has moved. But base salary tells only part of the story. Per diem home health nurses typically earn $40–$55/hour without benefits, travel home health contracts pay $1,700–$3,200/week, and the right combination of specialty, geography, and employment structure can move total compensation significantly above or below the headline figures.
This guide breaks down what home health RNs earn across every dimension: national averages, state-by-state data, experience tiers, employment setting, shift differentials, certifications that command premiums, and the career ceiling for nurses who want to advance.
At a glance
| Source | National average (annual) | Hourly rate | Methodology |
|---|---|---|---|
| BLS (SOC 29-1141, May 2025) | $97,550 median / $101,420 mean | $46.90 median | All RNs – not home health-specific; broadest sample |
| Salary.com (May 2026) | $90,694 | $44 | Employer job postings and third-party compensation surveys; home health RN-specific |
| Vivian Health (2025) | ~$100,609 annualized | $48.37 | Active job postings and BLS-weighted data; home health RN-specific |
| ZipRecruiter (March 2026) | $75,459 | $36.28 | Job posting data; lower estimate likely reflects geographic mix of postings |
| Vivian Health (Vivian Hire, 2025) | ~$77,459 annualized | $37.24 | BLS-weighted permanent placement data – narrower methodology |
Methodology note: The BLS Occupational Employment and Wage Statistics survey (SOC 29-1141) covers all registered nurses and does not break out home health specifically. It remains the most statistically rigorous dataset but is not a home-health-specific figure. Salary.com and Vivian Health use job posting and employer survey data that is more specific to the specialty but has smaller sample sizes. Use the $87,000–$91,000 range as the most defensible working estimate for a staff home health RN, and read it against the $97,550 all-RN median rather than assuming a specialty premium.
National average RN salary context
For comparison: the BLS national RN median across all settings and specialties is $97,550/year ($46.90/hour) in the May 2025 OEWS release. Home health specialty sources cluster below that figure, which is a change from earlier vintages: the all-RN median rose roughly 13% between May 2023 and May 2025, driven largely by acute care and by sharp gains in previously low-wage states, while home health agency pay – constrained by Medicare’s fixed 30-day period payments under the Patient-Driven Groupings Model (PDGM) rather than by hospital labor markets – moved less.
The BLS industry series confirm the gap directly. In May 2025 the median RN working in home health care services (NAICS 6216) earned $84,930, against $100,210 in general medical and surgical hospitals and $85,510 in nursing care facilities. The home health mean is noticeably higher at $93,580, which tells you the setting has a long upper tail: per diem, on-call, and senior case manager earnings pull the average up while the typical staff nurse sits near the median.
The autonomy premium and the complexity of OASIS-E2 documentation are real, and they show up in per diem and travel rates rather than in staff base salary. A home health RN comparing an offer against the national median should expect to sit at or slightly under it on base, and to close the gap through per diem pickup, on-call, and mileage reimbursement.
For a full breakdown of RN salaries by specialty and setting, see the RN salary guide.
Salary by experience level
Experience has a meaningful effect on home health RN compensation, primarily through negotiated base salary increases, case complexity assignments, and eligibility for case management or supervisory roles.
| Experience tier | Typical annual range | Notes |
|---|---|---|
| Entry (less than 1 year home health, 1–2 yr acute care) | $70,000–$82,000 | Most entry-level home health RNs come with prior acute care experience – their first year in home health is still an adjustment period; some agencies offer lower starting pay during orientation |
| Early career (1–3 years home health) | $80,000–$90,000 | Independent caseload established; OASIS accuracy proven; eligible for per diem pickup |
| Mid-career (3–6 years) | $88,000–$98,000 | Salary.com data shows mid-level ($91,709 at 2–4 years) consistent with this range |
| Senior (6–10 years) | $93,000–$105,000 | Salary.com senior level ($96,102 at 5–8 years); eligible for clinical educator, OASIS specialist, or case manager titles |
| Lead / expert (10+ years) | $96,000–$110,000+ | Salary.com expert level ($96,416 at 8+ years); salary growth flattens at this tier without moving into management |
Salary by employment setting
How you work in home health – staff employee, per diem, or travel contract – has a larger effect on compensation than experience alone at many career stages.
| Setting | Hourly rate | Annual equivalent | Benefits |
|---|---|---|---|
| Staff RN (full-time) | $40–$52 | $83,000–$108,000 | Full employer benefits (health, dental, PTO, 401k) |
| Per diem RN | $40–$55 | Variable (no guaranteed hours) | None – must self-fund benefits |
| Travel home health (contract) | $45–$65 taxable base + stipends | $88,000–$167,000 total package | Agency-provided; typically lower than staff employer benefits |
| VA Home-Based Primary Care (salaried) | $41–$60 equivalent | $85,000–$125,000 | Federal benefits (FEHB, FERS pension, TSP, 13 sick days/yr, 13–26 vacation days/yr) |
| Case manager / supervisor | $41–$50 | $85,000–$105,000 | Full employer benefits; salaried at most agencies |
Per diem premium
Per diem home health nurses receive a higher hourly rate than staff nurses – typically $40–$55/hour versus the staff equivalent of $40–$52/hour. The premium reflects the absence of guaranteed hours, the lack of employer-provided benefits, and the scheduling flexibility agencies rely on. A per diem nurse who fills consistent hours can match or modestly exceed a staff nurse’s gross earnings, but must budget separately for health insurance, retirement contributions, and income variability.
Travel home health nursing
Travel home health is a growing segment of the travel nursing market, driven by staffing shortages at agencies nationwide. Travel contracts follow a 13-week assignment model and include a combination of taxable hourly pay and tax-free stipends (housing, meals, incidentals) – the same structure as hospital travel nursing.
Current market rates for travel home health RN assignments:
- Weekly gross pay range: $1,700–$3,200 per week
- California assignments: up to $3,592/week (AMN Healthcare, current listings)
- New York assignments: up to $2,744/week
- Assignment length: typically 13 weeks; some 14–26 week contracts available
Travel home health contracts sometimes include a company vehicle or mileage reimbursement in addition to the standard stipend structure, since visiting nurses drive to patient homes. Confirm vehicle arrangements with the agency before accepting any assignment.
For a full explanation of travel nursing pay packages – including how the taxable/non-taxable split works and how to evaluate total compensation – see the travel nurse salary guide.
Geographic salary variation
Location is the single largest driver of home health nurse salary variation – more than experience or setting at the extremes.
Top 10 highest-paying states
Based on combined data from Vivian Health and Salary.com (2025–2026):
| State | Average hourly (Vivian) | Average annual (Salary.com) |
|---|---|---|
| California | $82/hr | $100,035 |
| District of Columbia | N/A | $100,416 |
| Massachusetts | $65/hr | $98,702 |
| Washington | $58/hr | $98,340 |
| New Jersey | $54/hr | $98,303 |
| Wisconsin | $60/hr | $96,200 (est.) |
| New York | $56/hr | $95,000 (est.) |
| Oregon | ~$58/hr (est.) | $94,000 (est.) |
| Hawaii | ~$50/hr (est.) | $93,500 (est.) |
| Alaska | ~$50/hr (est.) | $93,000 (est.) |
State-by-state salary table
The following data is drawn from Vivian Health (2025 average hourly rates for active home health RN positions). The BLS SOC 29-1141 covers all RNs, not home health specifically, so there is no survey-grade state series for this specialty – the figures below come from job-posting data and should be treated as estimates rather than precise surveys.
Read the annualized column as a rate conversion, not as a staff salary. Vivian’s averages are drawn from active job postings, a pool that skews toward travel and per diem contracts, which carry a substantial rate premium over permanent staff positions. Converting those rates at 2,080 hours therefore produces numbers well above what a staff home health RN in the same state earns. California illustrates the gap: $82/hour annualizes to $170,560, while Salary.com’s California staff estimate in the table above is $100,035 and this guide’s national working range is $87,000–$91,000. Both figures are defensible measurements of different things. Use the annualized column to judge what a full-time per diem or travel schedule could yield in a given state, and the Salary.com column to benchmark a staff offer. A handful of small-sample states – Kansas, Missouri, and New Mexico among them – sit implausibly high against their neighbors for this reason and should be treated with particular caution.
| State | Average hourly (Vivian Health) | Rate annualized at 2,080 hr (not a staff salary) |
|---|---|---|
| Alabama | ~$35 | ~$72,800 |
| Alaska | ~$50 | ~$104,000 |
| Arizona | ~$42 | ~$87,360 |
| Arkansas | $41 | $85,280 |
| California | $82 | $170,560 |
| Colorado | $47 | $97,760 |
| Connecticut | $40 | $83,200 |
| Delaware | $48 | $99,840 |
| Florida | $39 | $81,120 |
| Georgia | $45 | $93,600 |
| Hawaii | ~$50 | ~$104,000 |
| Idaho | ~$38 | ~$79,040 |
| Illinois | $49 | $101,920 |
| Indiana | ~$38 | ~$79,040 |
| Iowa | $29 | $60,320 |
| Kansas | $55 | $114,400 |
| Kentucky | $31 | $64,480 |
| Louisiana | $32 | $66,560 |
| Maine | ~$40 | ~$83,200 |
| Maryland | $50 | $104,000 |
| Massachusetts | $65 | $135,200 |
| Michigan | $41 | $85,280 |
| Minnesota | $39 | $81,120 |
| Mississippi | ~$31 | ~$64,480 |
| Missouri | $51 | $106,080 |
| Montana | ~$38 | ~$79,040 |
| Nebraska | ~$38 | ~$79,040 |
| Nevada | ~$44 | ~$91,520 |
| New Hampshire | $49 | $101,920 |
| New Jersey | $54 | $112,320 |
| New Mexico | $51 | $106,080 |
| New York | $56 | $116,480 |
| North Carolina | $46 | $95,680 |
| North Dakota | ~$38 | ~$79,040 |
| Ohio | $43 | $89,440 |
| Oklahoma | $49 | $101,920 |
| Oregon | ~$55 | ~$114,400 |
| Pennsylvania | $49 | $101,920 |
| Rhode Island | ~$45 | ~$93,600 |
| South Carolina | $32 | $66,560 |
| South Dakota | ~$34 | ~$70,720 |
| Tennessee | $30 | $62,400 |
| Texas | $45 | $93,600 |
| Utah | ~$40 | ~$83,200 |
| Vermont | $34 | $70,720 |
| Virginia | $52 | $108,160 |
| Washington | $58 | $120,640 |
| West Virginia | ~$33 | ~$68,640 |
| Wisconsin | $60 | $124,800 |
| Wyoming | ~$38 | ~$79,040 |
| District of Columbia | ~$55 | ~$114,400 |
States marked ~est. use BLS all-RN state data as a proxy where direct home health job posting data was limited. Source: Vivian Health (2025 active job postings); Salary.com (2025–2026 employer data); BLS OEWS (May 2025, SOC 29-1141). Annual figures calculated on a standard 2,080-hour full-time basis – per diem and part-time nurses will earn proportionally less.
Shift differentials and on-call pay
Home health nursing does not involve shift differentials in the traditional sense – there are no night shifts, and most visits occur during daytime hours. However, agencies do pay premiums for:
- Evening visits (after 5 or 6 p.m.): typically $2–$5/hr above base rate
- Weekend visits: $2–$5/hr differential, or a flat weekend premium per visit
- On-call stipend: most agencies pay a small hourly on-call stipend – typically $2–$4/hr – for carrying the on-call phone during off hours
- Callback pay: when an on-call nurse travels to a patient, compensation shifts to full hourly rate (sometimes 1.5x) for the duration of the visit plus travel time
On-call patterns vary widely. A nurse covering a territory of 40 patients one weekend per month can expect 2–5 phone calls and 0–2 in-person callbacks. Agencies with higher acuity caseloads generate more on-call activity.
Certification salary premium
Holding relevant certifications is associated with modestly higher compensation and stronger negotiating position, particularly when moving to case manager, clinical educator, or agency supervisor roles.
| Certification | Issuing body | Estimated premium | Notes |
|---|---|---|---|
| OASIS-E2 competency (internal) | CMS / agency-verified | $1,000–$3,000/yr or assignment eligibility | Not a formal credential but required for complex caseloads and some supervisory roles |
| CWCN (Certified Wound Care Nurse) | WOCNCB | $2,000–$5,000/yr | Particularly valuable at agencies with wound care specialty caseloads |
| RN-BC Home Health (ANCC) | ANCC | $1,000–$3,000/yr | Exam retired; ANCC now offers this credential for renewal only, so it is open to current holders and not to new candidates |
| PHN (Public Health Nurse) | State certification (varies) | $1,000–$2,000/yr | Relevant for community health and VNA settings |
| CHPN (Certified Hospice and Palliative Nurse) | HPCC | $2,000–$4,000/yr | Relevant for hospice transition roles; renewal every four years requires HPAR points plus a Situational Judgment Exercise |
Certification premiums in home health are not as formally structured as in hospital settings (where many union contracts include explicit cert pay). At most agencies, the benefit is negotiated individually at hire or during performance reviews rather than automatically added to base pay.
Career ceiling: salary at advanced roles
| Role | Typical annual range | Path from staff RN |
|---|---|---|
| Staff home health RN | $75,000–$110,000 | Entry point |
| Case manager (home health) | $85,000–$105,000 | 2–4 years home health experience |
| Clinical supervisor / team lead | $80,000–$100,000 | 3–5 years; strong OASIS record |
| Director of nursing (home health agency) | $90,000–$130,000 | 5–8 years; MSN or BSN + management experience |
| VP of clinical operations | $130,000–$180,000 | Senior leadership; MBA/MSN preferred |
| Home-based primary care NP | $110,000–$140,000 | Requires MSN/NP licensure; see NP pathway |
| CRNA (advanced practice ceiling) | $236,590 median (BLS May 2025) | Requires BSN + ICU experience + CRNA school |
The home health track does not lead to the highest nursing salaries in isolation. The highest-earning clinical nurses are CRNAs ($236,590 BLS median), followed by NPs and CNSs in specific specialties. Home health nursing is most financially rewarding when combined with advancement into management or advanced practice – the clinical experience translates directly into effective leadership of home health programs.
For nurses interested in the NP pathway from a home health background, see the how to become a palliative care NP guide.
For a baseline comparison across all RN settings and specialties, see the RN salary guide.
FAQ
How much do home health nurses make compared to hospital nurses?
Less, on base pay. BLS May 2025 industry data puts the median RN in home health care services at $84,930, compared with $100,210 in general medical and surgical hospitals – a gap of roughly $15,000. The gap narrows to about $10,800 at the mean ($93,580 vs $104,360), because home health has a long upper tail. Hospital RNs at unionized facilities, particularly in California and the Pacific Northwest, also benefit from formal step increases. Where home health closes the distance is through per diem and travel premiums, on-call pay, and tax-free mileage reimbursement, which can bring a high-utilization home health nurse level with or above a hospital staff nurse, particularly outside union markets.
Do home health nurses earn more than SNF nurses?
About the same for a typical nurse, and the answer flips depending on which average you use. In BLS May 2025 industry data, the median RN in nursing care facilities earned $85,510 against $84,930 in home health care services, so SNFs edge ahead by under $600 at the median. At the mean, home health leads ($93,580 vs $89,330), because its top earners pull further ahead. Both settings sit about $15,000 below general hospitals at the median. The difference between the two is small next to geography: the gap between a low-wage and a high-wage state runs to tens of thousands of dollars.
How does per diem home health pay work?
Per diem home health nurses are paid an hourly rate (typically $40–$55/hour) with no guaranteed hours. Agencies call per diem nurses to cover caseload gaps, on-call shifts, or vacation coverage. Pay is higher than staff to compensate for the lack of benefits and guaranteed income. Nurses working consistent per diem hours can earn more gross income than staff equivalents, but must self-fund health insurance and retirement savings.
Do home health nurses get mileage reimbursement?
Yes. Most agencies reimburse mileage for driving between patient homes at the IRS standard business mileage rate or a close approximation. The IRS set the 2026 business rate at 72.5 cents per mile from January 1, then raised it mid-year to 76 cents per mile effective July 1, 2026, so confirm which rate your agency is applying for the current period. Some agencies provide a company vehicle for high-mileage roles. Reimbursement at or below the standard rate under an accountable plan is not taxable income, which adds meaningfully to total compensation for nurses with large caseload territories.
What is the starting salary for a home health nurse?
New home health RNs with one to two years of acute care experience typically start in the $70,000–$82,000 range, with variation by state and agency. High-cost states, hospital-based home health programs, and VA positions tend to offer higher starting rates. Some agencies offer lower orientation-period pay – confirm the starting rate and the post-orientation rate separately.
Related guides
- How to become a home health nurse – requirements, OASIS, employers, step-by-step pathway
- RN salary guide – national and state salary data across all nursing settings
- Travel nurse salary guide – how travel pay packages work and what home health travel nurses earn
- How to become a palliative care NP – advanced practice pathway for home-based and community care
- How to become a registered nurse – starting point for nurses early in the pathway
References
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics, Registered Nurses (SOC 29-1141),” OEWS May 2025. National median annual wage: $97,550; mean: $101,420; median hourly $46.90.
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics, Nurse Anesthetists (SOC 29-1151),” OEWS May 2025. National median annual wage: $236,590; mean: $248,320.
- U.S. Bureau of Labor Statistics, “Occupational Outlook Handbook: Registered Nurses,” Employment Projections 2025–2035 (released 27 August 2026, superseding the 2024–2034 round): 6% growth, 3,465,400 jobs in 2025, approximately 180,800 openings per year.
- Salary.com, “Home Health Nurse Salary in the United States,” 2026.
- Vivian Health, “Home Health Registered Nurse Pay and Active Job Posting Data,” 2025.
- Centers for Medicare & Medicaid Services (CMS), “Outcome and Assessment Information Set (OASIS-E2) Guidance Manual,” effective April 1, 2026.
- Internal Revenue Service (IRS), “Standard Mileage Rates,” 2026 (72.5 cents/mile January 1 – June 30; increased to 76 cents/mile effective July 1, 2026).
- Wound, Ostomy and Continence Nursing Certification Board (WOCNCB), “Certified Wound Care Nurse (CWCN) Certification,” 2025.
- U.S. Bureau of Labor Statistics, OEWS May 2025 industry-specific estimates for SOC 29-1141, retrieved via the BLS Public Data API (series OEUN…29114113 median, …04 mean), accessed October 1, 2026. Home health care services (NAICS 6216) median $84,930, mean $93,580; general medical and surgical hospitals (6221) median $100,210, mean $104,360; nursing care facilities (6231) median $85,510, mean $89,330.
- American Nurses Credentialing Center (ANCC), “Home Health Nursing Certification (RN-BC),” renewal-only credential. https://www.nursingworld.org/our-certifications/home-health-nurse-renewal/
- Hospice and Palliative Credentialing Center (HPCC), “How to Recertify” – CHPN renewal requires HPAR plus the Situational Judgment Exercise on a four-year cycle, accessed October 1, 2026. https://www.advancingexpertcare.org/hpcc/recertification/how-to-recertify/
- Salary.com, “Nurse Case Manager Salary,” October 1, 2026 (25th–75th percentile $85,351–$104,066). https://www.salary.com/research/salary/listing/nurse-case-manager-salary