Home Care Service Rate Sheet
A 4-page fee schedule for non-medical home care, from core hourly rates through premiums and a one-client estimate.
For a USA home care agency that wants a rate sheet separate from the service agreement. You get one editable Word file, plus 1 agency instructions page to remove before use.
What’s included
- What the rates cover, what they leave out, the service area, and a non-medical scope note
- Core service rates, visit-length tiers, and a shared-household discount
- Time-of-day premiums, holidays, live-in and overnight, mileage, minimums, and cancellation rules
- A client quote with a proposed week, estimate totals, and an acknowledgment
- Agency instructions page, to remove before use
Add your logo and name
- Open Word. Replace the Your Logo Here box on the rate sheet with your logo.
- Put your agency name on the Agency Name line.
- Put your address, phone, email, and website on the lines under it.
- Delete the instructions page and save. Fill the quote page in Word for each client.
Editable templates for your agency to adapt. Not legal advice, not a license to operate, and not HIPAA software. This sheet is not the service agreement. Match the numbers and policies to your state rules before anyone signs.
Buy Now – $5.52
Instant download via Payhip · Editable Word (.docx) · Secure checkout
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