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Run the Payroll Fee Auditor →Blog · Payroll Management · Home Health
Home Health Agencies: Managed Payroll for Small Businesses (Under 25 Employees) (2026)
Managed payroll for a small home health agency is a complexity decision, not a headcount one: at $45 per employee with no monthly minimum a 10-person home health agency pays $450 a month. BEG: $45 per employee per month inside the payroll software you already use, live in 3 to 5 days.
What managed payroll costs a small home health agency
At $45 per employee per month with no monthly minimum and no setup fee, a 5-person home health agency pays $225 a month, a 10-person one $450 and a 20-person one $900, all-inclusive. The cost grows one employee at a time, so there is no headcount to wait for. Payroll software at roughly $40 to $150 a month plus $5 to $12 per employee is cheaper in raw dollars for a single-state, all-W-2, hourly-and-salary payroll. The question is whether this home health agency is that payroll.
The complications that decide it for home health agencies
Since January 1, 2015, home care agencies and other third-party employers cannot claim the companionship services exemption and must pay minimum wage and overtime after 40 hours even when the worker is jointly employed by the household. The exemption itself covers fellowship and protection only, with care limited to 20 percent of hours per consumer per workweek and no medically related tasks.
Visit-based aide pay, travel time reimbursement, Medicaid billing vs payroll and live-in caregiver rules: each is a pay code that self-service software ships blank, and each is a place a small home health agency with no payroll specialist gets it wrong for years before an audit or a wage claim finds it. One of these, or an employee in a second state, or a first garnishment order, is the point where the managed price stops being a premium.
What a small home health agency is already subject to
Below 50 employees the federal lines already crossed are e-filing at 10 information returns, OSHA logs at 11 unless the industry is on the exempt list, Title VII and the ADA at 15, and the ADEA and COBRA at 20. None of them wait for a payroll department to exist.
The rules behind this page, with sources
General information, not legal advice. Every rule below was read on the agency page linked next to it.
- Since January 1, 2015, home care agencies and other third-party employers cannot claim the companionship services exemption and must pay minimum wage and overtime after 40 hours even when the worker is jointly employed by the household. The exemption itself covers fellowship and protection only, with care limited to 20 percent of hours per consumer per workweek and no medically related tasks. [DOL Fact Sheet #79A]
Read the full guide to managed payroll by company size, and the rest of the home health agency payroll library.
Managed Payroll, Handled.
BEG manages payroll at $45 per employee per month, all-inclusive. Get an instant cost comparison for your business.
Frequently Asked Questions
Is managed payroll worth it for a home health agency under 20 employees?
When there is a complication: visit-based aide pay, a second state, a garnishment, or a classification question about registered nurses and LPNs. Without one, software is the cheaper price for a simple payroll and this page says so.
What does a 10-person home health agency pay?
$450 a month: 10 employees at $45 per employee, all-inclusive, with no monthly minimum and no setup fee.
Which home health agency rule most often breaks a self-service setup?
Since January 1, 2015, home care agencies and other third-party employers cannot claim the companionship services exemption and must pay minimum wage and overtime after 40 hours even when the worker is jointly employed by the household. The exemption itself covers fellowship and protection only, with care limited to 20 percent of hours per consumer per workweek and no medically related tasks.
What does managed payroll cost for a home health agency?
$45 per employee per month, all-inclusive, inside the payroll software you already use, with no monthly minimum. Visit-based aide pay, travel time reimbursement and Medicaid billing vs payroll are configured at setup, not billed as add-ons.
Related Resources
Anthony leads payroll solutions at Business Executive Group, a national managed payroll firm serving businesses across industries including Home Health Agencies. BEG manages payroll at $45 PEPM, all-inclusive, with deep expertise in compliance, multi-state filing, and industry-specific payroll requirements. Get instant pricing at beghr.com.
Authoritative source: U.S. Department of Labor: Wage and Hour Division
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