How Much Should You Charge for Foot Care Nursing?
The honest answer is that most foot care nurses are undercharging, and the reason is that almost nobody does the arithmetic.
Ask "how much should I charge for foot care nursing?" in any nursing group and you'll get a dozen numbers with no reasoning attached. Someone charges $45. Someone charges $175. Neither can tell you why, and neither number helps you.
The problem with copying someone else's rate is that their costs, their drive time, their market, and their income needs are not yours. A rate that works beautifully in dense suburban Los Angeles will not survive rural Michigan, and a rate that supports a part-time side practice won't replace a full-time salary.
So here's the actual method, and the number most nurses get wrong.
Start with what you need, not what others charge
Pricing from the outside in — looking at competitors and landing somewhere near them — is how nurses end up trapped. You pick a number that sounds reasonable, build a client base around it, and then discover two years later that a full week of visits doesn't cover your life.
Price from the inside out instead. Start with the income you need, add what it costs you to deliver a visit, account for taxes, and divide by the number of visits you can realistically perform. That gives you a floor. Then check the floor against your market.
If your floor is above what your market will pay, you have a volume or routing problem, not a pricing problem. That distinction matters, and we'll come back to it.
The cost most nurses forget: drive time
This is the single biggest error in mobile foot care pricing.
A 45-minute visit is not a 45-minute visit. It's 45 minutes of care plus 20 to 30 minutes of driving, parking, carrying your bag in, setting up, sanitizing, and packing out. Your real time per visit is closer to 70 or 75 minutes.
Nurses who price against a 45-minute clock are quietly donating a third of their working day. If you see 18 clients a week, unbilled travel and setup time is eating roughly 8 hours — a full working day every week, unpaid.
Drive time is also the cost you have the most control over, which is why it's the first thing to look at when your numbers don't work.
What actually goes into a visit rate
Six things. Miss any one and your rate is too low.
- Your target income. What you need to take home after taxes, not revenue.
- Taxes. Self-employed nurses face income tax plus self-employment tax. Many land between 25% and 35% of profit. Confirm yours with an accountant.
- Supplies per visit. Gloves, mask, sanding bands, underpad, wipes, sterilization pouches. Usually $7 to $12.
- Mileage. Miles per visit times the current IRS standard rate. At 18 miles a visit this is often $12 or more — more than your supplies.
- Fixed monthly costs. Liability insurance, phone, website, scheduling software, licensing, accounting. Commonly $200 to $400 a month.
- No-shows and cancellations. You will travel for visits you don't get paid for. Build that in rather than pretending it won't happen.
What this looks like with real numbers
Take a nurse who wants $55,000 in take-home income, working 18 visits a week for 48 weeks, with a 6% no-show rate, $9 in supplies and 18 miles per visit, and $275 a month in fixed costs.
Two things stand out. Taxes cost more per visit than supplies and mileage combined, which catches nearly everyone moving from a W2 job where withholding was invisible. And of a $120 visit, the nurse keeps about $68 — roughly 56%.
That last figure is worth sitting with. If you're charging $75 a visit, you are not earning $75. After costs and taxes you're keeping something closer to $30.
What the market actually supports
Private-pay nursing foot care commonly runs $75 to $150 per visit, with the higher end in dense metropolitan markets and for higher-acuity clients. Facility contracts often sit lower per visit but make up for it in routing, since seeing six residents in one building strips the drive time out of every visit after the first.
If your calculated floor lands inside that range, you're in workable territory. Verify against providers near you before committing.
If your floor comes out above $150, resist the urge to just charge more. Usually one of three things is true:
- Your visit volume is too low. Fixed costs and your income target are being spread across too few visits.
- Your routing is inefficient. Long drives between scattered clients inflate cost and destroy capacity.
- Your income target needs more time. A practice being built alongside other work may need a year or two of growth before it supports a full salary.
Density is almost always the better lever than price. Two clients in the same building beats one client twelve miles away, every time.
Run your own numbers
Rather than working this out on paper, I built a free calculator that does it. Put in your income target, visit volume, drive time, and costs, and it works backward to the rate that actually gets you there — plus your break-even rate and effective hourly.
Open the Pricing CalculatorShould you publish your prices?
Mostly yes, with a caveat.
"Contact for pricing" filters out more potential clients than most nurses realize. Adult children researching care for a parent are comparing options at 11pm, and a site with no pricing gets closed. You lose people who would have happily paid.
The caveat is that foot care visits genuinely vary. A routine trim on healthy nails and a complex diabetic visit with thickened mycotic nails are not the same work. Publishing a starting rate or a range handles both problems: "Routine visits from $120" qualifies buyers without locking you into a number for clinical situations you haven't seen yet.
Raising rates on existing clients
Every nurse who undercharged at the start eventually faces this, and it feels worse than it is.
A few things that make it manageable. Give 60 days notice in writing rather than mentioning it at a visit. State the new rate plainly without a lengthy justification — apologizing invites negotiation. Raise everyone at once rather than case by case, because selective pricing becomes unmanageable and eventually awkward when clients compare notes. And expect to lose a few. Losing 10% of clients while raising rates 25% leaves you ahead on both revenue and time.
The nurses who struggle most with this are the ones who wait until they're resentful. Annual reviews are easier than emergency corrections.
The mistake underneath all of this
Setting a rate once and never revisiting it.
Supply costs rise. Fuel prices move. Your skills improve and your visits get more efficient. Your client mix shifts toward higher acuity. Insurance premiums climb. A rate that was right in your first year is quietly wrong by your third.
Put a recurring reminder in your calendar to rerun your numbers once a year. It's a twenty-minute task that compounds more than almost anything else you'll do in the business.
If pricing is the thing genuinely holding your practice back — not the arithmetic, but what your specific market will bear and how to position against local competition — that's the most common subject of a strategy call. And if you're still building the business side out, the resources page has the operational templates, forms, and outreach materials from an active practice.
This article is general business information from an independent foot care nursing practice. It is not financial, tax, or legal advice. Tax rates and deductible mileage rates vary by year and situation — confirm your own numbers with a qualified accountant. Scope of practice and billing rules vary by state; verify with your own Board of Nursing.
