Travel Nurse and Locum Expense Reimbursement Rules

To simplify healthcare expense management for under $10/user (2026), businesses should stay up-to-date on these rules to avoid common mistakes.

• High-cost localities: $329 per day
• Other localities within CONUS (Continental United States): $230 per day

The portion of these rates that is treated as paid for meals is:

• High-cost localities: $86 per day
• Other localities within CONUS: $74 per day

Calculating Reimbursements for Mileage and Transportation Expenses

To reimburse locum tenens staff and travel nurses for mileage and transportation expenses, you'll need to follow these guidelines:

• For lodging, receipts are mandatory for all expenses, regardless of the amount. You can reimburse up to $80 per day for M&IE within the continental United States (CONUS) and $86 per day for M&IE outside the continental United States (OCONUS).

Remember to keep accurate records of all expenses and provide receipts for lodging expenses.

This plan requires proper documentation, including receipts and records of business-related expenses.

• Keep detailed records of all business-related expenses, including receipts and invoices.

It's also essential to note that state income tax laws can vary, and healthcare businesses should be aware of these differences when reimbursing travel expenses. Check with the relevant state authorities for specific guidelines and regulations.

Remember to keep all receipts and records for at least three years in case of an audit.

Navigating the 'Tax Home' Rule and Accountable Plan Requirements

When reimbursing travel nurses for housing and meals, it's essential to understand the "tax home" rule. This residence must be outside the area of their temporary assignment. The assignment itself must be temporary, meaning it's expected to last no more than a year.

• Travel nurses must maintain a valid tax home outside the area of their temporary assignment.
• The assignment must be temporary, lasting no more than a year.
• Travel nurses working in multiple states must file non-resident state returns in each state where income was earned.

When determining the tax home, consider the following:

1. Does the travel nurse have a permanent residence outside the area of their temporary assignment?
2. Is the assignment temporary, lasting no more than a year?

Accurate documentation is crucial to support the "tax home" rule. Keep records of the travel nurse's permanent residence, the temporary assignment location, and the duration of the assignment.

State-Specific Considerations for Reimbursement Rules and Taxation

To ensure compliance, it's essential to familiarize yourself with the specific regulations in your state.

First, check your state's tax laws to determine whether they require employers to withhold state income tax from employee reimbursements. Some states exempt certain types of reimbursement, such as meal and lodging expenses, from state income tax.

Next, review your state's laws regarding the tax treatment of stipends.

It's also crucial to understand your state's rules regarding the timing of expense submissions.

Finally, consult with a tax professional or accountant who is familiar with your state's tax laws to ensure you're in compliance with all applicable regulations.

Remember to keep detailed records of all expense reports, including dates, amounts, and descriptions of expenses. This will help you and your tax professional navigate any potential audits or disputes.

• Check your state's tax laws for specific regulations on reimbursement and taxation.
• Review your state's rules regarding the tax treatment of stipends.
• Understand your state's requirements for timely expense submissions.
• Consult with a tax professional or accountant familiar with your state's tax laws.