How I Make As Much As An Extra $8,000 Per Month Working PRN Home Health Physical Therapy – Part 2

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Welcome to Part 2 of this 2-Part series on how physical therapists and occupational therapists can maximize income potential when working prn home health.

To recap, in How I Make As Much As An Extra $8,000 Per Month Working PRN Home Health Physical Therapy – Part 1 we learned:

  1. How to best balance your physical therapy or occupational therapy full-time job’s schedule with your prn home health job’s schedule
  2. How to go about scheduling your home health patients
  3. How to be prepared for both expected and unexpected circumstances

In Part 2, you will learn about the following:

  1. How to keep your costs minimal but still be successful
  2. How to know which work relationships matter for different circumstances
  3. How and why to keep your documentation and finances organized
  4. How to maintain control of which patients and how many patients you see

Let’s get started.


Keeping expenses low will help increase your profit. Here are several ways you can do that.

Home Exercise Program (HEP):

Consider utilizing a free HEP program, such as HEP2Go, to lower software or app costs.

Or, get access to both an HEP program as well as unlimited CEUs by signing up with MedBridge. Lucky for you, I negotiated the lowest prices that a physical therapist, occupational therapist and speech therapist will find so be sure to use this link and save $175 when signing up with MedBridge.

Also, you can email the handouts to the patient rather than spending on paper and ink for printing.


Research the gas stations in your area to know which one is the cheapest and most convenient rather than waiting until you’re running on empty. My favorite is Costco.

Food and Drink:

Invest in a large water bottle and cooler for your car. Not only does it save money to make your own lunch, but you may not have time to grab a bite to eat in between patients.


The business of home health is built on relationships. If you can navigate the logistics of how these relationships affect your ability to increase your income, this can be of tremendous value.

Agency Patient Coordinators:

For a refresher on what an agency care coordinator does, refer back to Getting Started in PRN Home Health Physical/Occupational Therapy – Part 2.

If you can build a good rapport with the patient coordinators at the agency, they may favor offering the patients to you rather than a physical therapist or occupational therapist at another company. This also minimizes the chance that they send the patient to the company you work for but then your company decides to offer the patient to your co-worker instead.

When meeting an agency patient coordination for the first time, be sure to make a good first impression and let that person know that you can take on more patients in your geographical area of coverage. That one conversation can end up leading to a new steady stream of patients for you.

The relationship you have with agency coordinators can prove to be of further value if you decide to the leave company you are working for in favor of another company. The agency may decide they prefer to send patients to you and care less about which company you are working for. This is especially true of past patients that have had positive experiences with you and are requesting to work with you again.

This can also be a helpful negotiation tactic when asking your company for a raise.

Agency Case Managers:

To recall what an agency case manager does, refer back to Getting Started in PRN Home Health Physical/Occupation Therapy – Part 2.

Agencies often provide you their general phone number to call and their receptionist will then either attempt to connect you with the case manager or take a message and inform you that the case manager will call you back when they have a chance. This process can easily leave you waiting for an undetermined period of time until you can get pressing questions answered.

It can be very helpful to establish a good rapport with the case manager for each of your patients so that you can reach them directly, either by their email for less pressing matters or by their cell phone for a more immediate response. This relationship actually makes their job easier as well, since they can reach out to you more directly.

In addition, if an agency’s case manager gets to know that you are communicative, reliable, and ethical, they can pass your reputation on to their patient coordinators and help you land more patients.

Agency Nurses:

The patients you are seeing may have a nurse assigned to their them. This is not always the case, but if it is and you have a pressing medical concern for one of your patients, the agency’s case manager can help put you two in touch or speak to the nurse on your behalf. The latter is usually the better option as it can help improve your efficiency.


Above, we noted that the business of home health is built on work relationships. However, it can be quite difficult to strengthen these relationships if you are not staying organized. Not only can a lack of organization make you appear incompetent to your patients and co-workers, but it affects your bottom line as well.

Have a separate email address:

Communicating by email allows you to easily address less pressing issues when it is convenient for you.

Keeping a separate email address solely for the use of your work in home health allows you to keep things more organized, such as accessing previously sent communications to make a note if you have received a response on messages you may have previously sent or to recall if you communicated something you intended to address.

The currency of home health is communication, and this can be improved especially when you begin to increase your patient caseload.

It also helps to have an email address that appears professional and simple for others to remember. A good example can be [email protected]. Setting this up before beginning work in home health will save you the hassle of trying to get everyone to remember that you changed your email address after you have already worked hard to establish strong professional relationships.

Again, if you are going to use email, just ensure you are using de-identified information so that you are still compliant with HIPAA. If this is too difficult, other forms of electronic communication do exist to assist with this, such as the HIPAA complaint TigerConnect app. Even still, a simple phone call can go a long way.

In any case, it is highly recommended that you obtain private liability insurance to protect yourself.

Have a Separate Bank Account:

Just as maintaining a separate email address can improve communication with co-workers, keeping a separate bank account for your home health income can improve communication for those of financial concern, such as paying taxes as an independent contractor, preparing for a big purchase or refinancing student loans.

A separate bank account can help establish exactly how much income you make on a consistent basis. This is important as, unlike your full-time job, this income source will typically vary. Setting up a direct deposit can also help improve efficiency and skip the mundane task of depositing paychecks.

Keep a Record of What You Expect to Be Paid:

After all of your hard work, the last thing you want to deal with is receiving a paycheck for an amount that is less than you expected. Unfortunately, this can happen. However, if you keep your own detailed log of which visits you have performed then getting the paycheck corrected can become an easier feat.

Create Templates:

While working in home health, you will often have to complete certain mundane tasks repetitively. For example, you may have to email an agency case manager requesting approval for a plan of care’s frequency after every patient you evaluate.

If you create a prepared template for such an email, you can make completing that task less time-consuming. Such a template can include an initial greeting, fill-in-the-blanks for the dates requested in the frequency, and a pre-written email signature. Just double-check your email before you send it so that all of your information is accurate.


You Have the Right to Refuse:

You always have the right to refuse a new patient.

Of course, the goal of the agency will be to get all of their patients assigned to therapists. Additionally, the goal of the company you are working for is to maintain their relationship with that agency by accepting as many of that agency’s patients as possible.

Therefore, you will likely feel pressure from both of these parties to take some patients you don’t necessarily want to take for reasons including the patient is located outside of your typical coverage area, you don’t have the time to see the patient the day they are requesting, your caseload is already full, the patient may have isolation precautions (ie COVID-19) that you don’t want to be exposed to, or they would like you to see the patient on your one day off and you’d rather have some downtime.

Whatever the reason, only accept the patient if you truly want to. Be aware that once you have accepted that patient, you can’t change your mind and give the patient back – you will be stuck with that patient.


You’re Replaceable:

If you take a vacation, when you come back from vacation, you may realize that agencies that were previously giving you patients may not be sending you patients now because they’ve found other physical therapists or occupational therapists either at your company or at other competing companies to send the patients to.

It helps to be a “Yes man” where, if you keep saying “yes” to accepting patients they will continue sending you more patients. On the other hand, if you refuse too often, then they can find someone else and stop sending you offers altogether.

If you build a strong rapport with agencies, though, you may find yourself receiving messages/phone calls still requesting your attention, even when they know you are on vacation. Therefore, this doesn’t mean to avoid taking any vacation, but it does demonstrate how your income from working as an independent contractor can ebb and flow and also how your work relationships, as previously covered above, can be quite valuable.


Your Office, Your Rules:

Even though you’re working a second job, you can keep your spirits high by setting the environment in your car to stay motivated and relaxed. Listening to music, audiobooks and podcasts are just a few options to consider. You can also snack throughout the day and drink water more often compared to the faster pace of an office or hospital setting job.


I hope you found the information covered in both parts of this 2-part series helpful. Keep in mind that working prn home health is just one of the many potential side hustles physical therapists and occupational therapists should consider. However, working prn home health has definitely been my favorite as it has helped me pay off over $300,000 in student loans, save for purchasing our first house, contribute to our retirement accounts and prepare for our first baby.

I would not have reached these financial goals by only working my full-time physical therapy job.

Do you work prn in home health? If so, any other aspects you might add? Or are you thinking about working in home health and looking for further advice? Are there any other aspects you’d like covered that this article didn’t touch upon?

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