Mileage

The mileage log home-health clinicians actually need

If you drive between patients all day, your mileage is probably the largest deduction on your return — and the easiest one to lose, because of how it's recorded rather than how much you drove.

The part people get wrong: it's about the record, not the total

Most clinicians reconstruct their mileage in April from a calendar and a rough memory of the routes. That number might even be accurate. The problem is that it's a reconstruction, and the IRS asks for records kept at or near the time of the drive — "contemporaneous" is the word that shows up in the guidance.

In practice, a log that was written down each day and a spreadsheet built ten months later can show the identical number and be treated very differently if anyone ever asks. The daily one is a record. The other is an estimate.

What a defensible log contains

You don't need anything elaborate. For each business drive, you want:

• The date
• The miles driven
• Where you went — the destination
• The business purpose — for us, that's "patient visit," which is about as clear as a purpose gets

You also want your vehicle's total annual mileage, because the deduction is about business use of a car you also drive personally.

Which drives count

The general shape of it, for someone self-employed who drives to patients:

• Between patients — yes. Driving from one patient's home to the next is ordinary business travel and it's the bulk of a home-health day.
• Home to your first patient — it depends. The plain commuting rule says the trip from home to your first work location isn't deductible. But home-health work often has no fixed office, and if your home qualifies as your principal place of business — where you do your scheduling, documentation and admin — the trips out from it can be treated as business miles. This is exactly the question worth asking a preparer once, because the answer changes your yearly total substantially.
• Errands mixed in — no. The detour to pick up groceries between visits isn't business mileage. Log the visit-to-visit distance.

Employee or contractor changes everything

This is the fork in the road, and a lot of clinicians don't realize which side they're on:

• 1099 / self-employed: business mileage is a deduction against your business income. It matters a lot, and the log is yours to keep.
• W-2 employee: under current federal rules, unreimbursed employee expenses generally can't be deducted the way they once could. Your mileage still matters — but as something your employer reimburses. A per-visit log is how you make sure a reimbursement check is right, and how you notice when it isn't.

Either way, the log earns its keep. It just gets pointed at a different target.

Standard mileage or actual expenses

Two methods exist. The standard mileage rate multiplies your business miles by a per-mile rate the IRS sets each year. Actual expenses means tracking gas, insurance, repairs and depreciation, then deducting your business-use percentage of the whole thing.

Most home-health clinicians use the standard rate because it's dramatically less bookkeeping — but both methods start from the same place: you have to know your business miles. There's no version of this where the log is optional.

2026 has two rates. The IRS raised the business rate mid-year, so miles before July 1 are worth 72.5¢ and miles after are worth 76¢. Here's how to split your log without redoing the year.

Rates change annually, so check the current-year figure on IRS.gov rather than trusting a number you saw in a blog post — including this one. Nothing here is tax advice; a preparer who knows your situation is worth the hour.

The habit that actually survives a real work week

Every clinician who keeps good records has the same thing in common: the logging happens during the day, not at the end of it. Not because they're disciplined, but because the record is a byproduct of something they were already doing.

That's the whole design idea behind VisitWell. You plan the day's route because you want the driving order. Marking a visit done takes one tap because you want to know what's left. The mileage log fills itself in behind those two actions, with real timestamps, and at the end of the month there's a printable, signable page. In January there's a button that prints the whole year.

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Keep reading

The 2026 mileage rate changed on July 1 — what that means for your log72.5¢ through June 30, 76¢ after. A year priced at one rate is wrong. How to split it without redoing your year. How to tell when an agency shorts you a visitThe pay-stub math most clinicians never check, and the record that settles it. Planning a home-health day that doesn't waste an hour drivingWhy visit order beats speed, and how time windows change the answer.