Home health aides, personal care assistants, and private-duty caregivers spend a real part of the workday driving between clients' homes — and the miles are rarely paid for. Whether that driving is worth 72.5¢ per mile to you at the 2026 IRS rate depends on one question before any other: are you an employee or a contractor? The answer decides whether you get a deduction, a reimbursement, or — without a log — nothing.
W-2 aides cannot deduct work mileage on the federal return. The 2017 tax law suspended the deduction for unreimbursed employee expenses, and 2025 legislation made that permanent. If you get a W-2 from an agency, your path is reimbursement, not a deduction — see below. If you get a 1099-NEC (private-duty work, a registry, your own caregiving business), you deduct the miles on Schedule C like any other business.
Which caregiving miles count as business miles
Business miles are miles driven for the work, regardless of who employs you:
- Between clients — leaving one client's home for the next. This is the bulk of an aide's deductible driving, and the part almost nobody logs.
- To the agency office mid-day for supplies, paperwork, or training, and back to a client afterwards.
- Errands for a client in your own car — the pharmacy, groceries, the doctor's office — when they're part of the job and not reimbursed.
- Driving a client to an appointment in your car. (The client may separately have a medical-mileage question of their own; your miles are business miles.)
- Training and certification sessions away from your regular work location.
Which miles don't count: the commute
Under the IRS's general rule, the trip from home to your first work location of the day, and from the last one home, is personal commuting. For an aide with several clients, the conservative reading is: home → first client = commuting, last client → home = commuting, everything in between = business. Two narrower exceptions exist — travel to a temporary work location outside your metropolitan area, and a home that qualifies as your principal place of business — but most aides don't fit either, and the safe assumption is that the first and last legs are personal. A tax professional can tell you if your situation is different.
Also personal: your own errands during the day, and any miles an agency reimburses you for.
If you're W-2: reimbursement is the play
Employers can reimburse business mileage tax-free under an accountable plan, up to the IRS standard rate — the same 72.5¢ per mile. Many agencies do reimburse client-to-client driving; some pay a flat rate well below the IRS figure; some don't pay at all. Three things worth knowing:
- Reimbursement at the full IRS rate is worth the same to you as the deduction would be to a contractor, and it's not taxable income.
- If your agency reimburses below the IRS rate, the shortfall is not deductible on the federal return. A few states still allow unreimbursed employee expenses on the state return — worth a question to your preparer.
- An accountable plan requires you to substantiate the miles to the employer — dates, miles, and destinations — which is exactly the log described below. No log, no reimbursement, even when the driving was real.
If you're 1099: deduct it on Schedule C
Contractors deduct business miles at the standard rate (72.5¢), plus parking and tolls, or by the actual-expense method (real car costs × business-use percentage — which requires the same log). Profit is subject to income tax and ~15.3% self-employment tax, so each 1,000 business miles saves roughly $200–300 in cash depending on your bracket. The 1099-NEC threshold is $2,000 for payments made in 2026; every dollar of caregiving income is reportable either way.
Worked example — private-duty aide, 2026
Rosa sees three clients a day, five days a week, and drives 7,200 miles a year between them and to the agency office — not counting her commute to the first client and home from the last.
As a 1099 contractor: 7,200 × 72.5¢ = $5,220 off her Schedule C profit — roughly $1,550 kept at a ~30% combined rate.
As a W-2 aide at an agency paying the IRS rate: the same 7,200 miles come back as $5,220 in tax-free reimbursement. At an agency paying a flat 45¢: $3,240, and the difference is lost. Without a log: nothing, in every case.
The substantiation checklist — for the IRS or for your agency
The IRS and an accountable plan want the same record. Vehicle expenses fall under the strict substantiation rules (§274(d)); an estimate is not a log.
- ☐ Every work drive with date, miles, destination, and purpose — "Client visit, Mrs. Alvarez, Oak Park" is enough; keep client detail consistent with your agency's privacy rules
- ☐ Entries made at or near the time — same day or that week, not reconstructed from the schedule months later
- ☐ Commute legs identified so they can be excluded honestly (a log that claims the drive home is a log an auditor distrusts)
- ☐ January 1 odometer reading each year
- ☐ Year-end totals: total / business / commuting / other miles
- ☐ Agency schedules, visit records, or timesheets kept as corroboration
- ☐ For W-2 aides: reimbursement claims submitted on the agency's timetable, from the same log
How Mile handles a caregiver's day
A day of six client visits is exactly the log that never gets written by hand. Mile records each drive automatically; name your clients' homes and the agency office as places and every drive labels itself ("Alvarez home → Chen home"), so the week is classified in a few taps. A commute adjustment excludes your home-to-first-client and last-client-to-home legs automatically, keeping the business total defensible. The monthly CSV works as a reimbursement claim for an agency, and the year-end PDF/CSV carries the four IRS fields, the rate applied, and the January 1 odometer block for Schedule C. Free for 40 automatic drives a month, ad-free on every plan.
Sources
- IRS, Publication 463 — Travel, Gift, and Car Expenses (commuting; temporary work locations; accountable plans; recordkeeping)
- IRS, Topic No. 510 — Business use of car
- IRS, Topic No. 514 — Employee business expenses
- IRS, Notice 2026-10 — 2026 Standard Mileage Rates
- IRS, Schedule C instructions — Part IV, Information on Your Vehicle