CPA guide • 2026 update
The "Reverse Bill Rate": How Much is Your Agency Keeping?
The bill rate is what the facility pays your agency. Understanding the travel nurse bill rate explained and agency margin helps you negotiate smarter and avoid underpaid contracts.
The Rules: How Bill Rates Work
- The hospital pays the bill rate. It covers your pay, stipends, payroll taxes, insurance, and agency profit.
- Agencies keep a margin. Margins vary, but transparency matters.
- Your pay split matters. Taxable wage vs. stipend impacts net pay and compliance.
The Math: Reverse Bill Rate Example
Assume a $90/hour bill rate for 36 hours.
| Scenario | Bill Rate | Estimated Agency Cost | Nurse Pay Package | Agency Margin |
|---|---|---|---|---|
| Scenario A (Fair) | $90 | $2,100 | $2,000 | $100 |
| Scenario B (High Margin) | $90 | $1,750 | $1,600 | $500 |
How to Evaluate Agency Margins
- Ask for a full pay breakdown (taxable + stipends).
- Research market bill rates for your specialty and location.
- Compare multiple agencies for the same facility when possible.
- Include benefits and reimbursements in total compensation.
FAQ
Can I ask the agency for the bill rate?
You can ask, but not all agencies disclose it. Competing offers can help you estimate.
What is a fair agency margin?
There’s no fixed rule; many agencies aim for 20–30%, but it varies by market and benefits.
Does a higher margin always mean a bad contract?
Not always. Some assignments include higher risk or better benefits, but you should still compare net pay.
Final Takeaway
Understanding the reverse bill rate gives you leverage. When you know the bill rate and agency margin, you can negotiate from a position of strength and focus on your true net pay.
Estimate your net pay in minutes
Use the calculator to compare taxable wages vs. stipends and see your true take-home.