WageTime runs payroll for pediatric private duty nursing agencies, the employers staffing RNs and LPNs on 12 and 16-hour shifts with medically fragile children. Medicaid pays a fixed rate per staffed hour, and what each case keeps is settled in the pay run.
Built for pediatric private duty nursing agencies. WageTime is a payroll and HR platform; it is not affiliated with, endorsed by, or sponsored by CMS, any state Medicaid program, or any managed care plan. Rates and program rules cited are from the public sources listed in the footer. This page is for agency employers and their payroll, not for families or job-seeking nurses.
Private duty nursing is the inverse of visit-based home care: instead of short stops across many homes, one nurse holds one child for a long block of hours, and Medicaid pays a fixed rate for each of them. Payroll is where those blocks either add up or quietly don’t.
A nurse who covers Monday, Wednesday, and Friday sixteens worked three days and 48 hours. Eight of those hours are overtime, and hourly nurses get it: LPNs generally can’t be treated as exempt professionals no matter how experienced they are. The schedule that looked light on the whiteboard was an overtime week the whole time.
Florida’s Medicaid schedule pays an RN hour at $32.23 and an LPN hour at $28.14. Out of that hour come the wage, the night differential, the overtime premium, and everything else the agency spends. When a shared-sibling shift bills the second child at half rate, the billing drops and the nurse’s wage doesn’t. The report showing which cases still clear usually arrives at year end.
The payer has the school schedule on file and pays nursing hours outside classroom instruction, so the case runs as school-run blocks, evening blocks, and night blocks from September to May. Then summer erases the timetable and the same child needs full days covered. Twice a year, every case reshapes itself, and the pay math follows.
In a 2025 study of families of children with medical complexity, only 61 percent had at least 90 percent of their approved nursing hours staffed, and one in five got less than half. Unstaffed hours are unbilled hours. The night differential, the case bonus, and a Friday pay day are not perks; they are how authorized hours become staffed ones.
By the week’s hours, not the shift count: three 16-hour shifts total 48 hours, and the 8 past 40 pay the premium even on a three-day week. Sleep time stays in; on shifts under 24 hours, WageTime counts every hour as work time.
| Shift | Day block | Night block |
|---|---|---|
| Mon · Case P-11516.0 hours · 7a-11p | 12.0 × $28.00 | 4.0 × $31.00 |
| Wed · Case P-11516.0 hours · 7a-11p | 12.0 × $28.00 | 4.0 × $31.00 |
| Fri · Case P-11516.0 hours · 7a-11p | 12.0 × $28.00 | 4.0 × $31.00 |
Replaces the schedule that hid an overtime week inside a three-day rotation.
Divide coded payroll by staffed hours: WageTime tags wages, differentials, and overtime to case codes and reports labor per code monthly. Florida’s October 2024 fee schedule pays RN hours at $32.23 and LPN hours at $28.14 after a 7.19 percent increase.
| Case | Labor cost | Labor per hour |
|---|---|---|
| Case P-102RN, days & nights · 224 hrs | $6,496.00 | $29.00 |
| Case P-115RN, night-heavy · 168 hrs | $5,544.00 | $33.00 |
| Case P-121LPN, school + home · 96 hrs | $2,688.00 | $28.00 |
| Case P-134LPN, two siblings · 112 hrs | $3,136.00 | $28.00 |
Replaces the case-level margin guess that waited for the year-end cost report.
Twice a year the case changes shape: September to May runs as school-run, after-school, and night blocks, and June flips to full-day home coverage. WageTime builds each case as blocks, publishes them to the staff app, and rebuilds the summer shape once.
| Block | Hours | Status |
|---|---|---|
| School runDana F., LPN · Mon-Fri 8a-3p | 35.0 | Published |
| EveningsMiguel S., LPN · M-F 3p-11p | 40.0 | Published |
| NightsYara H., RN · Sun-Thu 11p-7a | 40.0 | Published |
| Weekend daysOpen shift · Sat-Sun 8a-4p | 16.0 | Unfilled |
Replaces the September rebuild that lived in a scheduler’s head, and the June one too.
WageTime onboards the parent as a regular W-2 hire, because these programs usually run through an agency’s payroll: 35+ states pay a parent or family member for part of their own child’s care, from Florida’s Family Home Health Aide program to Missouri’s agency-employed family nurses.
| Employee | This week | Weekly cap |
|---|---|---|
| Carla M. · parent aideFL Family Home Health Aide | 40.0 hrs | 56 hrs |
| Denny O. · parent LPNMO HealthNet PDN | 38.5 hrs | 40 hrs |
| Sofia T. · parent aideFL Family Home Health Aide | 24.0 hrs | 56 hrs |
| Grace L. · family CNAState family-CNA program | 30.0 hrs | 40 hrs |
Replaces the paper packet a parent filled out at the kitchen table, twice.
Payroll mechanics, run as WageTime configuration: differentials priced for the blocks nobody wants, case bonuses when a hard case fills, weekly pay day on unlimited runs, and readiness records that clear a nurse before the case starts.
| Item | Due | Status |
|---|---|---|
| Trach & vent competencyrequired before start | Sep 19 | Completed |
| Night differential pay code+$3.00/hr on night blocks | Sep 22 | Configured |
| Case-fill bonusflat-amount pay code | First check | Configured |
| RN license renewalrenewal document on the record | Oct 31 | 30-day alert |
| CPR certificationcard attached, no action due | Mar 2027 | Current |
Replaces the case that started before the training did, and the bonus promised in a text message.
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 demoHourly private duty nurses generally do: federal guidance treats hourly RNs as overtime-eligible, and LPNs generally do not qualify as exempt learned professionals regardless of experience. Three 16-hour shifts total 48 hours, so 8 of them pay the premium. Whether a specific salaried role is exempt is a question for your employment counsel; WageTime computes the overtime either way, on the weighted-average rate when the week mixes pay codes.
On a shift under 24 hours, yes: federal rules count the entire shift as work time, including hours the employee is permitted to sleep, so a 10p-6a block pays wall to wall. Different arrangements exist for shifts of 24 hours or more and belong with your employment counsel. In WageTime the night block simply runs as paid hours with its differential, and everything folds into the overtime math.
School shifts run as their own blocks in WageTime: payers keep the child’s school schedule on file and pay nursing hours outside classroom instruction, so a school-year case splits into school-run, after-school, and night blocks, each with its own nurse and rate. WageTime publishes the blocks to the staff app and flows approved hours into payroll; when summer flips the case to full days, you rebuild the pattern once.
Yes, in 35+ states, usually through an agency’s payroll: Florida’s Family Home Health Aide program employs a family member through a licensed agency at $25 an hour, capped at 8 hours a day and 56 a week; Missouri caps a family RN or LPN at 12 a day and 40 a week. WageTime onboards the parent as a W-2 hire with a program-specific pay code, hours visible against the cap.
Yes in many states: Ohio denies PDN claims for dates of service on or after August 1, 2025 without a matching EVV visit record. We import clock hours from your EVV or agency-management system, CareVoyant, KanTime, Alora, or HHAeXchange, so there’s no double entry; tell us your system on the demo and we’ll confirm the exact flow for your setup. WageTime’s mobile clock does not satisfy state EVV requirements.
The billing side commonly steps down: Florida pays the second child in the same home at 50 percent of the rate and the third at 25 percent, while the nurse’s wage stays whole. That squeeze is what case-level job costing is for: WageTime tags the shift’s wages to the shared case and reports labor per staffed hour against what the case bills. Claims stay in your agency-management or billing system.
$50 a month per company plus $10 per person paid that month, including a parent aide who worked one weekend. Runs are unlimited, weekly pay and off-cycle checks cost nothing extra, and every federal, state, and local tax is filed automatically with W-2s and 1099s at year end. No long-term contracts; cancel anytime. Migration is full-service and paid; we scope it on the demo.
Twenty minutes with a payroll specialist on a live demo company: a three-sixteens week trued up on the weighted average, labor per staffed hour beside your state’s PDN rate, a case built as school and night blocks, and a family caregiver onboarded with the program’s cap on a report.
Book a 20-minute demo