WageTime is payroll for hospice agencies, where care happens at all hours and revenue arrives per patient day. The 2 a.m. callback, the per-diem chaplain, and the IDG meeting all run as pay codes on the same check, with overtime on the weighted-average rate.
Built for hospice agencies. WageTime is a payroll and HR platform; it is not affiliated with, endorsed by, or sponsored by CMS or the Medicare program. Medicare payment figures cited are from the CMS FY2026 hospice final rule (CMS-1835-F).
Hospice payroll is shaped by two facts: revenue arrives per patient day, and care happens at all hours in other people’s homes. Everything hard about paying a hospice team follows from those two.
The phone rings at 2 a.m.: telephone triage for twenty minutes, a drive across the county, a time-of-death visit until dawn. That single night touches a stipend, an hourly rate, a callback tier, travel time, and mileage. Generic payroll systems see one number scribbled on Monday.
Medicare pays a fixed rate per patient day. The team earns by the hour, the visit, and the callback, and nobody rings a bell when the second number crosses the first. The cost side of a patient day is a payroll question, and in most hospices it waits for the cost report.
A chaplain at a per-visit rate, a social worker at another, a bereavement coordinator paid hourly, and a mandated plan-of-care review every 15 days that puts all of them in one room, on the clock. Per-diem pay across four disciplines is its own payroll specialty, and the spreadsheet running it knows it.
In a patient’s final week, RN and social worker visit minutes drive an add-on payment in 15-minute increments. The biller needs exact minutes, the nurse needs the wages, and an auditor needs the two to match. Three needs, one time record, usually three systems.
Volunteers must cover at least 5 percent of paid patient-care hours, with records to show it. The denominator comes from payroll, the numerator from a binder, and the surveyor wants the math. And a volunteer must never turn out to be an unpaid employee: the DOL has collected back wages from a hospice for exactly that.
WageTime prices the rotation as a stack of pay codes: a flat stipend for holding the phone, an hourly code for telephone triage, per-unit rates for callback visits, and travel time between callbacks as paid hours, every wage line folding into the weighted-average overtime rate.
Replaces the on-call notebook that priced a 2 a.m. death visit three different ways in one quarter.
A hospice earns a fixed per-diem while its labor is paid by the hour, the visit, and the stipend, so labor cost per patient day is the number an administrator actually manages. It lives in payroll, not the EMR, and WageTime reports it monthly.
| Level of care | Labor cost | Labor per day |
|---|---|---|
| Routine home care, days 1-60918 patient days | $78,948.00 | $86.00 |
| Routine home care, days 61+1,204 patient days | $71,036.00 | $59.00 |
| Continuous home care11 patient days | $9,713.00 | $883.00 |
| General inpatient26 patient days | $11,206.00 | $431.00 |
| Inpatient respite14 patient days | $2,772.00 | $198.00 |
Replaces the cost-per-day guess rebuilt once a year from the cost report.
An interdisciplinary group is a payroll roster, not just a care team: the hospice CoPs require a physician, a registered nurse, a social worker or counselor, and a pastoral or other counselor, and WageTime runs each per-diem discipline on its own pay codes.
Replaces four pay spreadsheets for four disciplines, reconciled by whoever had time that week.
The service intensity add-on (42 CFR 418 Subpart G) pays for RN and social worker visit time in a patient’s last 7 days, in 15-minute increments, turning minute-level time records into revenue documents. The minutes already live in WageTime: GPS-stamped punches, locked timesheets, biller reports.
| Case | RN minutes | MSW minutes |
|---|---|---|
| Case 41-2083 visits | 150 | 60 |
| Case 41-2154 visits | 240 | 0 |
| Case 41-2212 visits | 90 | 45 |
| Case 41-2262 visits | 105 | 30 |
Replaces the Friday hunt through visit notes for the minutes the biller needed yesterday.
From payroll. Hospice is the only provider type Medicare requires to run on volunteers: services must equal at least 5 percent of paid patient-care hours (42 CFR 418.78), and WageTime totals that denominator by staff group on a schedule.
| Staff group | Care hours | Share |
|---|---|---|
| RNs & LPNs | 3,412 | 44.6% |
| Hospice aides | 2,976 | 38.9% |
| Social workers & counselors | 861 | 11.3% |
| Chaplains | 402 | 5.2% |
Replaces the quarter-end spreadsheet that rebuilt the 5 percent math from check stubs.
Full-service payroll is $10 a month per person paid that month, plus $50 a month per company, with unlimited runs. No long-term contracts, no per-run charges.
Off-cycle runs and bonuses cost nothing extra. No long-term contracts; cancel anytime.
Example: 50 people paid × $10 + $50 company = $550 for the month
HR & hiring, onboarding, PTO, time tracking, benefits, and workers’ comp are optional add-ons, priced separately when you’re ready.
See a demoOn-call pay runs as its own pay codes: a stipend for the on-call shift itself, hourly pay for telephone triage, tiered rates for callback visits, and travel time between callbacks. For non-exempt staff, every one of those wage lines folds into the weighted-average regular rate, so the week’s overtime computes on everything earned.
Both models are common in hospice: salary with a rotating call schedule, or hourly with per-visit and callback pay. Whether a case manager is overtime-exempt is a question for your employment counsel. WageTime runs either structure, and when an hourly week mixes rates, overtime trues up on the weighted average automatically.
Chaplain and social worker visits price as their own per-visit pay codes, and IDG meeting or documentation hours run hourly on the same check. Bereavement coordinators, counselors, and music therapists follow the same pattern. When a non-exempt week mixes per-visit and hourly pay, the overtime premium computes on the blended regular rate.
Routine home care pays $230.83 per day for days 1-60 and $181.94 from day 61; continuous home care pays $1,674.29 per 24-hour day, inpatient respite $532.48, and general inpatient $1,199.86. The aggregate cap is $35,361.44 per beneficiary. Figures from the FY2026 hospice final rule; payroll is where the labor side of those days gets managed.
SIA pays for RN and social worker visit time in the last 7 days of life, in 15-minute increments up to 4 hours a day. WageTime’s time tracking supplies the minute-level record: GPS-stamped punches, per-visit pay codes, and hours reports scheduled to your biller. Claims themselves stay in your EMR and billing process.
$50 a month per company plus $10 per person paid that month, including per-diem staff who only worked one visit. Unlimited runs, off-cycle checks, and every federal, state, and local tax filing are included, with W-2s and 1099s at year end. No long-term contracts. Onboarding is full-service and paid; we scope it on the demo.
Twenty minutes, a payroll specialist, and a live demo company: your rotation priced as pay codes, a callback week trued up on the blended rate, the IDG roster paid per visit and per hour, and the patient-care-hours report your compliance team keeps asking for.
Book a 20-minute demo