Home Care Billing and Payroll Software
Built for PT, OT & ST Agencies.

Auto-build invoices from submitted visits. Run 1099 contractor payroll off the same data. Pay therapists directly. One HIPAA-compliant platform for home care and home health therapy agencies — no second tool, no double entry, no reconciliation.

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Most home care and home health agencies run their billing and payroll across two or three separate tools — QuickBooks for invoices, Gusto or a spreadsheet for contractor pay, and a text-message thread for collecting visit data from therapists in the field. Visit data ends up living in three places, drifting out of sync, and burning several hours per week of admin time just keeping the systems aligned.

The point of integrated home care billing and payroll software isn't to digitize each tool separately — it's to run both workflows off the same source of truth: the visit data your therapists log in the field.

📌 Who This Is For

This page is for owners of home care and home health agencies that contract PT, OT, and ST therapists to see patients in their homes. If you bill insurance directly or primarily employ W-2 staff with fixed schedules, this is a different model and different tools apply.

The Real Cost of Separate Billing and Payroll Tools

When billing lives in QuickBooks and payroll lives in Gusto, every visit your therapists complete has to be entered into both — once to invoice the home health agency, again to calculate what the contractor is owed. Same data, two destinations, double the entry work, double the opportunity for error.

What that actually looks like across a typical billing cycle for a 10-therapist agency:

That's not billing software working for you. That's you doing the work manually and using software as filing cabinets.

One Source of Truth: How Integrated Software Actually Works

The premise of purpose-built home care billing and payroll software is that visit data should be entered exactly once — by the therapist who completed the visit — and that single entry should drive both invoicing and payroll automatically. No re-entry. No reconciliation. No drift.

1
Therapist logs a visit in the app
Date, patient ID, agency, discipline, visit type. Submitted from phone or browser right after the visit. One entry, captured in real time.
Single entry point
2
Platform applies the right rates automatically
Looks up the home health agency's contracted rate for that visit type and the therapist's contracted pay rate. Both calculations happen from the same submitted visit.
Auto rate lookup
3
Invoices generate at billing cycle close
One invoice per home health agency, itemized by visit. Delivered through a HIPAA-compliant secure portal — never as an email attachment containing PHI.
Billing output
4
Contractor payroll calculates from the same data
No separate payroll run. The platform knows what each contractor is owed because it's the same data the invoices were built from. Review and approve at pay time.
Payroll output
5
Pay contractors directly via Stripe
ACH transfer straight to their bank account from inside the platform. Every payment logged automatically against their year-to-date total for 1099-NEC tracking.
Payment + 1099

Why Generic Tools Aren't Enough

QuickBooks alone
Built for: General business invoicing
No therapist visit submission, no per-visit-type rate matrix, no contractor payroll, no HIPAA-compliant invoice delivery. You still build everything manually before QB touches it.
Gusto / ADP for payroll
Built for: W-2 employee payroll with tax withholding
Designed around salary and hourly pay, not per-visit calculation for 1099 contractors. Doesn't connect to the visit data that should drive contractor pay.
Insurance billing platforms
Built for: Claim submission to Medicare and commercial insurers
Built around CPT codes, payer rules, and clearinghouse submission. None of that applies if you're invoicing home health agencies, not insurers.
Spreadsheets + Email
Built for: Everything, optimized for nothing
Flexible but not scalable. No automation, no HIPAA compliance, no 1099 tracking. Works at 2–3 therapists. Breaks down fast as the agency grows.

What Integrated Home Care Billing and Payroll Software Has to Do

Capability 01
Field-Based Visit Submission
Therapists log visits in real time from any device. Date, patient ID, agency, visit type, discipline — captured at the source so it doesn't have to be transcribed later.
Capability 02
Per-Agency, Per-Visit-Type Billing Rates
Each home health agency has its own rates per visit type. Configure once per agency; the platform applies them automatically to every visit on every future invoice.
Capability 03
Per-Therapist, Per-Visit-Type Pay Rates
Same model on the payroll side. Each contractor has their own pay rates per visit type. Set once, applied to every visit automatically. No manual payroll computation.
Capability 04
Automated Invoice Generation
Close a billing cycle and invoices generate per home health agency — itemized by therapist, date, and visit type. No manual invoice building from scratch each cycle.
Capability 05
HIPAA-Compliant Invoice Delivery
Visit data is PHI. Invoices can't be emailed as plain attachments. Delivery has to go through a secure authenticated portal — non-negotiable for home care billing.
Capability 06
Direct Contractor Payments + 1099-NEC Tracking
Pay contractors via ACH from inside the platform. Every payment logged automatically against year-to-date totals so January 1099 filing is a report pull, not a reconstruction.

How HomeHealthSync Compares to the Typical Two-Tool Stack

Capability
QuickBooks + Gusto + Spreadsheet
HomeHealthSync
Visit data entry
Manual, multiple places
✓ Once, by therapist
Invoice generation
Manual build per cycle
✓ Auto from visits
Contractor payroll calculation
Separate sheet, manual reconcile
✓ Auto from same visits
HIPAA-compliant invoice delivery
✗ Email attachments
✓ Secure portal
Direct contractor payments
Bank portal or checks
✓ Stripe ACH
1099-NEC year-end tracking
Manual reconstruction in January
✓ Always current
Total monthly software cost
$90–$300/mo + admin hours
$60–$149/mo

Pricing

HomeHealthSync is priced for growing home care and home health agencies — not enterprise healthcare systems:

Starter
$60
/month
Up to 8 active therapists
Visit tracking · Auto invoicing · Multi-agency billing · Contractor payroll · Stripe payments · HIPAA-compliant delivery · 1099-NEC tracking
Growth
$149
/month
Unlimited therapists
Everything in Starter · Unlimited therapists · Unlimited agencies · Priority support

30-day free trial, no credit card required. Replaces what most agencies currently pay across QuickBooks + Gusto + manual admin time — at a lower combined cost.

See Billing and Payroll Run Off One Visit Entry

No signup needed — explore a live agency account and walk through the integrated workflow from visit submission to invoice to contractor payment.

Frequently Asked Questions

What is the best home care billing and payroll software for a PT, OT, or ST agency?

HomeHealthSync is built specifically for PT, OT, and ST home health agencies. It combines billing and 1099 contractor payroll in a single platform driven by the same visit data — invoices generate automatically per home health agency at contracted rates, and contractor payroll calculates from the same visits without any re-entry.

Why use one platform for home care billing and payroll instead of separate tools?

When billing and payroll live in separate tools, visit data has to be entered twice — once to invoice the home health agency, again to calculate contractor pay. Every duplicate entry is an opportunity for the two systems to drift apart, and reconciling them at month-end is hours of work. Integrated software runs both off the same submitted visits, so they can't disagree.

Does HomeHealthSync replace QuickBooks for a home care agency?

For invoicing and accounts receivable — yes. Many agencies keep QuickBooks for general accounting (expense categorization, P&L, tax prep), but the invoice-generation workflow moves into HomeHealthSync where it can be driven off visit data instead of built manually.

Is home care billing and payroll software HIPAA compliant?

It has to be. Invoices include patient identifiers and visit details — that's PHI. HomeHealthSync is HIPAA compliant end to end, delivers invoices through a secure authenticated portal, and a Business Associate Agreement is available.

How does payroll work for 1099 therapists?

Each contractor has a per-visit-type pay rate configured once. When a visit is submitted, the platform automatically calculates what's owed. At pay time, you review and pay directly via Stripe ACH. Every payment is logged automatically for year-end 1099-NEC reporting.

How much does home care billing and payroll software cost?

$60/month for up to 8 active therapists or $149/month for unlimited therapists. Both plans include integrated billing and payroll, multi-agency invoicing, HIPAA-compliant delivery, direct Stripe contractor payments, and 1099-NEC tracking. 30-day free trial, no credit card required.

AC
Andrew C., PT, DPT
Physical Therapist & Founder, HomeHealthSync

Andrew built HomeHealthSync after running a home health therapy agency and burning weekends reconciling QuickBooks invoices against a Gusto payroll sheet. HomeHealthSync runs billing and payroll off a single visit entry — so the two can't disagree.