Home health nurse: can I deduct or get reimbursed for mileage?

It depends on how you are paid. A home health or visiting nurse on a W-2 with an agency can no longer deduct unreimbursed mileage on the federal return: the log serves to claim reimbursement from the employer, tax-free at the standard rate, and many agencies pay mileage between patients on exactly that basis. A per diem or 1099 nurse deducts the miles on Schedule C, like any independent contractor.

A route is a lot of short drives: six, eight, ten patients a day across a county, two or three hundred business miles a week, ten thousand or more a year. At the 2026 IRS rate of 72.5 cents a mile, 10,000 miles is worth $7,250. A route rarely repeats, which is exactly why a written record beats an estimate, and why nobody writes down eight addresses a day in a notebook.

Watch the ends of the day: home to the first patient and last patient back home follow the commute rules, usually not deductible or reimbursable unless your home qualifies as your business base. Everything in between, patient to patient, is business mileage without question.

If your visits are in a calendar, Google Calendar, Outlook or the ICS feed of your agency's scheduling system, Kilevo reads it. Each visit with an address becomes a round trip from your home or office to the patient; the visit title becomes the purpose. Check the visits of one day and click Link into a tour so that each leg starts from the previous patient. To protect privacy, keep the address in the location field and a neutral label in the title: Kilevo never reads or stores the attendees of an event.

A visit without an address produces no trip: make sure your appointments carry the patient's address. The Kilevo for home health nurses page details the method, and business miles vs commuting draws the line at both ends of the route. For your case, check with the IRS or your accountant.