Mileage Tracking for Home-Visit Therapists: IRS Rules and What Actually Counts

If you're an EI, OT, PT, or speech therapist doing home visits, your car is your clinic hallway — and the miles between visits are real money. Here's how the deduction works, what counts, and how to keep a log that holds up. (We're not tax professionals, and this isn't tax advice — it's the working knowledge every home-visit therapist should bring to their tax preparer.)

The standard mileage rate, in one paragraph

The IRS sets a standard rate per business mile each year — for 2025 it was $0.70/mile; check IRS.gov for the current year's rate. Multiply your logged business miles by the rate and that's your deduction (the alternative — actual vehicle expenses — is usually more bookkeeping than it's worth for most therapists, but ask your preparer). At 70 cents, a therapist driving 600 business miles a month is looking at roughly $5,000/year in deductions. Unlogged miles are simply donated back.

What counts as business miles

• Between clients: yes, always. Client A's house to Client B's daycare is the clearest business mile there is.
• Home to your first visit, and last visit to home: it depends. This is the commute question, and the answer hinges on whether your home qualifies as your principal place of business (a qualifying home office where you do your admin, notes, and scheduling). If it does, those first and last legs are generally business miles; if not, they may be commuting. This single distinction can swing thousands of dollars — it's the one question worth fifteen minutes with a tax professional.
• Errands for the caseload (supply runs, clinic meetings): generally yes.
• Personal detours: no — and mixing them in is how logs lose credibility.

What a defensible log looks like

The IRS standard is a contemporaneous record: date, start point, destination, business purpose, and miles — kept as you go, not reconstructed in April. In practice that means one of:

1. A spreadsheet you actually keep up. Our free caseload tracker has a mileage tab with the rate in one editable cell and a running deduction estimate.
2. Software that logs the chain automatically. Casedaisy records each day as a route — home → visit → visit → home — computing every leg from your actual schedule and locations, with an export formatted for tax time and a setting for whether to include the home legs, since that answer is yours and your preparer's to make.

The mistakes that cost therapists money

Reconstructing from memory. A log built in April from a calendar is weaker evidence and always undercounts. Logging round trips from home for every visit. Your real day is a chain, not a star — if you go home → Mia → Leo → home, the Mia→Leo leg is the one people forget. Forgetting the return leg. The drive home after the last visit is part of the same question as the morning leg — count it consistently with your preparer's guidance. Skipping small hops. Two miles between a daycare and a home visit, five days a week, is 500+ miles a year.

FAQ

Do I need odometer readings? Point-to-point distances with dates and purposes are the practical standard most preparers want; consistent methodology matters more than odometer photos.

I get partially reimbursed by my agency — can I still deduct? Only unreimbursed business miles are potentially deductible, and employment status (W-2 vs 1099) changes the answer significantly. Preparer question.

What about teletherapy days? No drive, no miles — which is exactly why your log should come from your actual schedule, not a per-client assumption.