A private nurse typically costs between $25 and $75 per hour, depending on the type of nurse you hire and whether you go through an agency or hire independently. For a full 8-hour shift, that translates to roughly $200 to $600 per day. The total you’ll pay depends on the level of care needed, where you live, how many hours you need, and how you find the nurse.
Hourly Rates by Nurse Type
Not every private nurse has the same training, and the price reflects that. Registered nurses (RNs) charge the most, typically $40 to $75 per hour. They handle complex medical tasks like wound care, IV therapy, medication management, and monitoring unstable health conditions. If you or a family member is recovering from surgery or managing a serious illness at home, an RN is usually what you need.
Licensed practical nurses (LPNs) fall in the middle at $25 to $50 per hour. They can administer medications, check vitals, and provide skilled care under an RN’s or doctor’s direction, but they can’t perform the full range of tasks an RN can. For many post-surgical recoveries and chronic condition management, an LPN provides the right level of care at a lower cost.
Certified nursing assistants (CNAs) are the most affordable option at $20 to $35 per hour. They assist with daily activities like bathing, dressing, eating, and mobility. If the primary need is personal care and companionship rather than medical treatment, a CNA is often the right fit.
Agency vs. Hiring Independently
One of the biggest factors in cost is whether you hire through a home care agency or find a nurse on your own. Agencies charge 30 to 50% more than independent caregivers. The national median hourly rate for agency-based in-home care is about $33 per hour, while independent caregivers often charge $20 to $25 per hour for comparable work. In expensive metro areas, the gap widens further. In the San Francisco Bay Area, for example, agencies charge $45 to $60 per hour.
That markup covers real things: the agency handles background checks, liability insurance, payroll taxes, backup staffing if your nurse calls in sick, and supervision. When you hire independently, you take on those responsibilities yourself. You become the employer, which means handling tax withholding, workers’ compensation insurance, and finding a replacement if something falls through. For families who are comfortable managing those details, hiring directly can save 20 to 30% compared to agency rates. For families who want simplicity and reliability, the agency premium buys peace of mind.
Most agencies also require minimum shift lengths, commonly 4 hours per visit. If you only need someone for 2 hours a day, you’ll still pay for 4. Independent nurses are sometimes more flexible on minimums, though this varies.
What Full-Time Private Nursing Actually Costs
The numbers climb quickly when care extends beyond a few hours. Here’s what typical scenarios look like at mid-range rates:
- Part-time (4 hours/day, 5 days/week): At $35/hour through an agency, expect roughly $700 per week or about $3,000 per month.
- Full daytime shift (8 hours/day, 7 days/week): At the same rate, that’s roughly $1,960 per week or about $8,400 per month.
- 24-hour care: Round-the-clock nursing, whether through multiple shift nurses or live-in arrangements, can run $15,000 to $25,000 per month depending on your location and the nurse’s qualifications.
Live-in nurses who stay overnight sometimes charge a flat daily rate rather than hourly, which can lower the per-hour cost. However, labor laws in most states require that live-in workers receive adequate sleep time, so true 24-hour medical monitoring usually requires two or three nurses rotating shifts.
Extra Charges to Expect
The hourly rate isn’t always the final number. Overnight shifts and weekend shifts often carry a differential, adding a few dollars per hour to the base rate. Holiday rates are common as well, sometimes at time-and-a-half, though federal law doesn’t require premium pay for holidays. Some agencies charge an initial assessment fee to evaluate the patient’s needs before care begins.
If the nurse needs to travel a significant distance, mileage or travel time charges may apply. Specialized skills like ventilator management, tracheostomy care, or pediatric nursing also push rates toward the higher end of the range.
What Insurance and Medicare Cover
Medicare covers some home nursing, but not the kind most people picture when they think of a private nurse. To qualify, you need to be homebound (meaning leaving your home is difficult or inadvisable due to your condition) and require skilled nursing care that is part-time or intermittent. Medicare defines that as up to 8 hours per day of combined skilled nursing and home health aide services, with a maximum of 28 hours per week. In some cases, that cap extends to 35 hours per week for a short period if your provider deems it necessary.
The covered services are specifically medical: wound care for surgical sites or pressure sores, IV therapy, injections, monitoring of serious or unstable conditions, and patient education. Medicare does not pay for 24-hour home care, personal care like bathing and dressing when that’s your only need, or homemaker services like cooking and cleaning.
Private health insurance varies widely. Some plans cover skilled home nursing after hospitalization for a limited number of days. Long-term care insurance, if you purchased a policy before needing care, is one of the few insurance types designed to cover extended private nursing. Medicaid may cover private duty nursing in some states, particularly for children with complex medical needs, but eligibility requirements are strict.
For most families paying out of pocket, the realistic expectation is that insurance offsets some of the cost for short-term skilled care but covers little to none of long-term private nursing.
Tax Deductions for Private Nursing
Private nursing costs that are medically necessary can qualify as a deductible medical expense on your federal taxes. The IRS allows you to deduct medical expenses that exceed 7.5% of your adjusted gross income when you itemize deductions. This applies to care for yourself, your spouse, or a qualifying dependent.
The key distinction is purpose. If the nursing care is primarily medical, the full cost is deductible. If someone is receiving care primarily for non-medical reasons (help with daily living rather than treatment of a condition), only the portion that qualifies as actual medical care can be deducted. Keep detailed records of the nurse’s duties, the medical condition requiring care, and all payments. IRS Publication 502 outlines the specifics for what qualifies.
How to Lower the Cost
If the price of private nursing feels overwhelming, a few strategies can help. Start by honestly assessing the level of care needed. Many families default to hiring an RN when an LPN or CNA would meet the actual needs at a significantly lower rate. Your doctor can help clarify what level of nursing skill is medically necessary.
Combining professional care with family caregiving is another common approach. Hiring a nurse for one 8-hour shift per day while family members cover evenings and nights cuts costs dramatically compared to round-the-clock professional care. Some families hire a nurse for the most medically intensive tasks (medication management, wound care, physical therapy exercises) and handle personal care themselves.
If you’re comfortable with the administrative responsibilities, hiring an independent nurse rather than going through an agency saves 20 to 30%. Nursing registries, which match families with independent nurses without providing full agency services, offer a middle ground at lower markup than traditional agencies. Finally, check whether your state has home and community-based waiver programs through Medicaid, which can subsidize home nursing for people who would otherwise need institutional care.