Travel Therapy Bill Rates Explained: What Agencies Won't Tell You

The bill rate is the single most important number in travel therapy that most therapists never see. Understanding it transforms you from a passive contract-accepter into an informed negotiator who knows exactly what you're worth.

What Is a Bill Rate?

The bill rate is the hourly amount that a healthcare facility pays your staffing agency for your services. When a hospital needs a travel PT and contacts an agency, they negotiate a bill rate — say, $85/hour. That $85/hour is the total revenue the agency receives for each hour you work.

From that bill rate, the agency must cover your taxable pay, your tax-free stipends, employer-side payroll taxes (FICA, FUTA, SUTA), workers' compensation insurance, health insurance contributions, professional liability insurance, and their operating margin (profit).

What's left after all those costs is the agency's margin — typically 20-30% of the bill rate.

How Bill Rates Are Determined

Bill rates aren't random — they're influenced by several market factors. Geographic location matters significantly because facilities in high cost-of-living areas or underserved regions pay higher rates. The clinical setting affects rates too, with acute care and SNFs typically commanding higher bill rates than outpatient. Demand and urgency play a huge role: a facility that has been trying to fill a position for months may increase the bill rate substantially. Finally, specialty and experience requirements matter — a position requiring wound care certification or acute care experience commands a premium.

Realistic 2026 ranges, based on community-reported packages: PT and SLP typically $60–$75/hour (up to about $90/hour in high-cost markets like California, NYC metro, Alaska, and Hawaii); OT typically $55–$70/hour (up to about $85/hour in high-cost markets); PTA $40–$55/hour; COTA $35–$50/hour. School-based contracts generally sit at the lower end of each band. Acute care, SNF, and home health tend toward the upper end.

Why You Usually Can’t Get the Bill Rate Directly

Most facilities prohibit recruiters from disclosing the actual bill rate — it’s typically written into the staffing contract as confidential. Asking is fine, but don’t expect a number. What you can do is insist on a complete written line-item breakdown of your pay package: taxable hourly rate, housing stipend, M&IE stipend, travel reimbursement, benefits valuation, overtime rate, and any guaranteed hours clauses. Compare offers from multiple agencies for the same assignment based on total weekly take-home, not on the hourly figure alone.

Working with two or three recruiters at different agencies for any given assignment is the most reliable way to identify when a package is below market — the comparison itself is the leverage.

Use our Pay Package Calculator to estimate the bill rate for any position and see where your pay package falls.

The Anatomy of a Bill Rate Breakdown

Let's walk through a real-world example. Say a facility pays a bill rate of $85/hour for a travel PT working 40 hours/week. That's $3,400/week in total revenue to the agency.

Here's approximately how that breaks down: your taxable hourly rate at $28/hour costs $1,120/week. Housing stipend at $1,200/week and M&IE stipend at $420/week bring your total compensation to $2,740/week. Employer payroll taxes (FICA, etc.) on the taxable portion run about $86/week. Workers' comp insurance adds roughly $68/week. Health insurance contribution is about $75/week. Professional liability insurance runs $15/week. That leaves the agency with $416/week or about $10.40/hour — a 12.2% margin.

This is a fair deal for both sides. The therapist takes home excellent pay, and the agency earns a reasonable profit for their services.

Red Flags: When You're Getting a Bad Deal

Compare your total weekly compensation (taxable pay + stipends) against the estimated bill rate revenue (bill rate × hours). If your total compensation is less than 65% of the bill rate revenue, you may be underpaid. Other red flags include an agency refusing to discuss bill rates at all, pay packages significantly below what other agencies offer for similar positions in the same area, and "take it or leave it" responses when you try to negotiate.

How to Use Bill Rate Knowledge in Negotiations

You don't need to know the exact bill rate to negotiate effectively. Research typical rates for your discipline, setting, and location. Compare offers from multiple agencies for the same or similar positions. Ask your recruiter directly — phrase it as a partnership question: "I'd like to understand the bill rate so we can figure out the best package structure together."

If an agency won't share the bill rate, that's their prerogative. But you can still use market data and competing offers to ensure you're getting a fair deal.