WageTime runs payroll for Medicare-certified home health agencies. CMS pays in 30-day periods, clinicians earn in visits and points, aides and office staff in hours: WageTime speaks all three currencies natively.
Built for Medicare-certified home health 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 CY2026 Home Health PPS final rule.
Certified home health runs on a currency exchange: CMS pays in 30-day periods, clinicians earn in visits and points, aides and office staff earn in hours. Payroll is the desk where all three settle every Friday, and a generic payroll system speaks only one of them.
Every discipline has its own rate card. A start of care pays more than a routine visit, a recert sits in between, a discharge has its own number, and the point sheet reconciling it all lives in a spreadsheet the scheduler and the payroll clerk both edit. When a nurse questions her check, the audit trail is an argument.
CMS’s own burden estimate puts the OASIS-E data at a start of care at 57.3 minutes, and the real visit runs longer before the late-night sync. Pay per visit and let the charting ride for free, and you are funding a wage claim: mixed per-visit and hourly work needs a genuine overtime true-up, not a shrug.
Fall below the threshold and the 30-day period collapses to per-visit payment. With CY2026 Medicare payments down 1.3 percent in aggregate, the question every administrator is asking (what does a visit actually cost us, by discipline?) is a payroll question wearing a billing costume.
The Conditions of Participation put hard numbers on your workforce file: 75 training hours before an aide serves patients, 12 in-service hours every 12 months, competency evaluations, supervisory visits on a 14-day clock. The surveyor doesn’t ask whether training happened. The surveyor asks to see the records.
WageTime runs per-visit pay as per-unit codes: one rate per discipline and visit type, hourly codes beside them on the same check. When the week mixes both, overtime trues up on the weighted-average regular rate, inside the run instead of a spreadsheet after the fact.
| Line | Rate | Amount |
|---|---|---|
| Start of care (OASIS-E)2 visits | $110.00 | $220.00 |
| Routine visits11 visits | $70.00 | $770.00 |
| Recertification1 visit | $95.00 | $95.00 |
| Case conference2.5 hrs · hourly | $40.00 | $100.00 |
| In-service training1.5 hrs · hourly | $40.00 | $60.00 |
| On-call stipend2 nights | $37.50 | $75.00 |
Replaces the point-sheet spreadsheet, and the paycheck that couldn’t explain itself.
Straight out of WageTime: every pay dollar coded to a discipline and visit type yields labor cost per visit, reported monthly. With CY2026’s base period at $1,933.61 and aggregate payments cut 1.3 percent, that number is the margin.
| Discipline | Labor cost | Cost per visit |
|---|---|---|
| Skilled nursing412 visits | $28,840.00 | $70.00 |
| Physical therapy186 visits | $16,275.00 | $87.50 |
| Occupational therapy74 visits | $6,475.00 | $87.50 |
| Speech pathology31 visits | $2,867.50 | $92.50 |
| Medical social work18 visits | $1,899.00 | $105.50 |
| Home health aide240 visits | $8,400.00 | $35.00 |
Replaces the year-end scramble to rebuild cost per visit from twelve months of check stubs.
WageTime splits on-call into separate pay codes: a stipend for carrying the phone, a per-visit rate when the phone wins, and a premium when the callback becomes a weekend start of care. Every one of those dollars folds into the weighted-average regular rate.
Replaces the on-call ledger in the DON’s notebook.
The records the CoPs name: 75 training hours before an aide serves patients, 12 in-service hours every 12 months, competency evaluations, current licenses. WageTime keeps that file as a side effect of running your workforce, so the survey answer is an export.
| Aide | In-service hours | Status |
|---|---|---|
| Gloria P.Competency on file · May 2026 | 12.0 of 12 | Complete |
| Anh D.Competency on file · Jun 2026 | 12.0 of 12 | Complete |
| Rob E.Competency on file · Apr 2026 | 10.0 of 12 | On track |
| Tomás V.Competency on file · Mar 2026 | 9.5 of 12 | Due in 2.5 hrs |
| Keisha B.Competency renewal Nov 2026 | 6.0 of 12 | Behind pace |
Replaces the survey-week binder hunt.
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 demoYes, and that’s the normal case in certified home health. Per-visit rates run as per-unit pay codes by discipline and visit type, hourly codes cover case conferences and in-services, and both land on one check. The week’s overtime then trues up on the weighted-average regular rate across everything earned.
Usually, yes. Courts have held that adding hourly pay for meetings or documentation to per-visit pay defeats the fee-basis professional exemption, which typically makes per-visit clinicians overtime-eligible. Whether a specific role is exempt is a question for your employment counsel; WageTime computes the blended-rate overtime either way.
Rate cards commonly price it higher, and the workload explains why: an OASIS-E start of care carries 203 data elements, and CMS’s own burden estimate is 57.3 minutes for the assessment data alone. In WageTime a SOC premium is simply another per-unit rate, and point-based plans map the same way.
We import visit and clock hours so there’s no double entry: visit counts and hours land against the right clinician and pay code instead of being re-keyed on Thursday. Tell us your EMR on the demo and we’ll confirm the exact flow for your setup: how visit types and point values map to pay codes, and where SOC premiums slot in.
Assign in-service training in WageTime’s learning module and completion records accumulate per aide, next to competency documents and license records with expiration alerts. The 12-hours-per-12-months requirement in 42 CFR 484.80 becomes a report you export, not a binder you assemble the week the surveyor calls.
$50 a month per company plus $10 per person paid that month. Runs are unlimited, weekly pay and off-cycle checks included, and every federal, state, and local tax is filed automatically with year-end W-2s and 1099s. No long-term contracts. Migration is full-service and paid; we scope it on the demo.
Twenty minutes with a payroll specialist on a live demo company: your visit types priced as pay codes, a mixed per-visit and hourly week trued up on the blended rate, labor cost by discipline on a scheduled report, and the in-service tracker your next survey will meet.
Book a 20-minute demo