Home care visit invoice template
Home care visit invoice template: personal care, companionship and medication visits from the visit log, weekend surcharges and carer travel per km.
Templates by industry
- Personal care visit, 45 minutes
- Companionship and shopping visit, per hour
- Medication prompt visit, 15 minutes
- Weekend and holiday surcharge
- Carer travel, per km
Preparation guide
Example workflow
Confirm scope and quantities
Example: reconcile the approval and work record for "Personal care visit, 45 minutes" to establish the quantity for this invoice.
Record delivery and acceptance
Check completion for every line, including "Carer travel, per km". Confirm completed services and quantities with the customer and retain the handover record.
Send the billing record
Send the final charges, delivery reference and due date to the customer, then reconcile payment against the invoice number.
Privately paid home care is billed by the visit, and the person paying is often a son or daughter who was not there. They need to see how many visits of each type took place, when, and why some cost more, such as weekend visits. This template separates personal care, companionship, short medication visits, surcharges and travel, and leaves the notes for the visit log, the care plan reference and who to contact about a missed visit.
Fields to prepare
- Deliverables and line items
- Personal care visit, 45 minutes, Companionship and shopping visit, per hour, Medication prompt visit, 15 minutes, Weekend and holiday surcharge, Carer travel, per km: record the quantities actually supplied and the service period.
- Personal care visit, 45 minutes
- Take visit dates and times from the log the carer signs, and say what the personal care included.
- Companionship and shopping visit, per hour
- Companionship and shopping visits run longer; give their hours and any money handled on the client’s behalf.
- Medication prompt visit, 15 minutes
- Short visits add up quickly; list their dates so the family can check them against the medication chart.
- Weekend and holiday surcharge
- Say which visits fell on weekends or public holidays and the surcharge per visit.
- Carer travel, per km
- Bill travel only if your terms include it, at the agreed rate per km.
- Intake and service
- Record the intake reference, service date, quantity and agreed service scope.
- Extras and handover
- Separate approved extras, supplied items and the completion or handover time.
- Scope to agree
- Bill each type of visit at its own rate with dates and times from the visit log, and say who receives the invoice when a relative pays.
Before sending
- Does “Personal care visit, 45 minutes” show the quantity actually supplied, not the quantity first quoted?
- Is “Companionship and shopping visit, per hour” charged at the rate the customer agreed to, with any change approved?
- Is “Medication prompt visit, 15 minutes” finished and accepted, or does it belong on a later invoice?
Show 5 more
- Does “Weekend and holiday surcharge” show the quantity actually supplied, not the quantity first quoted?
- Is “Carer travel, per km” charged at the rate the customer agreed to, with any change approved?
- Reconcile the booked scope with any extra services actually supplied.
- Check that services included in a package have not also been billed separately.
- Match completed work to the order or approval record, and confirm the payment due date and amounts already received.
Worked example with sample figures
The figures below are invented to show how the template adds up: 5 lines in USD, with an example tax rate of 8%.
| Item | Quantity × unit price | Amount |
|---|---|---|
| Personal care visit, 45 minutes | 20 × $32.00 | $640.00 |
| Companionship and shopping visit, per hour | 8 × $28.00 | $224.00 |
| Medication prompt visit, 15 minutes | 12 × $14.00 | $168.00 |
| Weekend and holiday surcharge | 4 × $9.00 | $36.00 |
| Carer travel, per km | 160 × $0.50 | $80.00 |
| Subtotal | $1,148.00 | |
| Sales tax (8%) | $91.84 | |
| Total | $1,239.84 | |
Net amount $1,148.00, sales tax $91.84, total payable $1,239.84.
What the document must show
The details an invoice has to show, and why each one matters, are set out in the guide below.
The sales tax depends on where the work is supplied, so set the rate that applies to your customer before sending.
Official rate reference: US government: state and local taxes
Full requirements: How to write an invoice: a step-by-step example
Frequently asked questions
Can the client reclaim these costs from insurance or public funding?
That depends on the scheme and on the client’s assessment, which vary by country. Show the visit details clearly and check with the scheme what a claim needs, without promising a refund you cannot confirm.
How do I invoice a visit the client cancelled?
Use the notice period in the care agreement. If a visit cancelled late is chargeable, list it with its date and mark it as cancelled, so the family does not mistake it for care that took place.
How is the sales tax worked out on this invoice?
The worked example above uses an example rate of 8%: $91.84 on a net amount of $1,148.00, for a total of $1,239.84. The editor recalculates all three when you change a quantity, a price or the country.
Is this template free?
Yes. You can fill in this template and print it or save it as a PDF without an account, and there is no payment step and no watermark on the document. Saving it to your account and downloading Excel or Word files need a free account.
Can I use it in another language or currency?
Yes. The document language can be set to any of 33 languages, and changing the country setting updates the currency, the date format and the tax rate.
Read next
Reading for the Home care visit invoice template: How to write an invoice: a step-by-step example and Invoice payment terms: Net 15, Net 30, due dates. The VAT and GST calculator works out the tax line for you.