What nurses can write off on their taxes depends almost entirely on whether they work as W-2 employees or 1099 independent contractors. Self-employed nurses can deduct licensing fees, malpractice insurance, scrubs and medical equipment, mileage, continuing education, home office costs, health insurance premiums, and retirement contributions on Schedule C. W-2 employee nurses lost the federal deduction for unreimbursed work expenses when the Tax Cuts and Jobs Act took effect in 2018, and the One Big Beautiful Bill Act made that elimination permanent, so an employee nurse’s federal write-offs are limited to items that don’t depend on employment status, such as education credits and student loan interest.
Why Your Employment Status Decides the Answer
Most nurses are W-2 employees. A hospital or clinic withholds income and payroll taxes and pays you on a schedule. Travel nurses, some consultants, and certain home health providers work instead as 1099 independent contractors, which the IRS treats as self-employed business owners who file a Schedule C.1Internal Revenue Service. About Schedule C (Form 1040), Profit or Loss From Business (Sole Proprietorship)
Before 2018, employees could deduct unreimbursed work expenses as miscellaneous itemized deductions on the portion exceeding 2% of adjusted gross income. That option is gone. The Tax Cuts and Jobs Act suspended it, and the One Big Beautiful Bill Act removed the expiration date, making the elimination permanent for 2026 and beyond.2Office of the Law Revision Counsel. 26 USC 67 – 2-Percent Floor on Miscellaneous Itemized Deductions If your employer requires you to buy your own stethoscope, scrubs, or continuing education courses and doesn’t reimburse you, you cannot deduct those costs on your federal return.
Two things soften that for employees. When your employer reimburses expenses through an accountable plan, the reimbursement isn’t taxable income to you. And a handful of states still allow employees to deduct unreimbursed business expenses on their state return, so checking your state rules is worth the few minutes.
Everything in the deduction sections below applies to self-employed nurses unless noted. The education credits and student loan interest sections apply either way.
Licensing, Certifications, and Professional Dues
The recurring costs of keeping your credentials current are deductible on Schedule C. State license renewal fees, typically $68 to $190 depending on the state, belong on Line 23 (Taxes and Licenses).3Internal Revenue Service. Instructions for Schedule C (Form 1040)
Specialty certification fees, including ACLS, PALS, and CRNA credentials, qualify the same way because they tie directly to your ability to practice in your specialty. Dues paid to the American Nurses Association or specialty nursing organizations are deductible too, but you cannot deduct the portion of dues that goes to lobbying or political activity. Most organizations will tell you what percentage of your dues is non-deductible.
Malpractice and Business Insurance
Professional liability premiums are deductible on Schedule C, Line 15. Individual nurse malpractice policies typically run between $106 and $828 per year depending on specialty and state, and the full premium is deductible.3Internal Revenue Service. Instructions for Schedule C (Form 1040) General liability, business property, and errors-and-omissions premiums go on the same line. Health insurance gets its own treatment further down.
Uniforms, Equipment, and Supplies
Clothing counts only if it’s required for work and unsuitable for everyday wear. Scrubs embroidered with a facility logo, surgical gowns, lead aprons, and non-slip surgical shoes pass. Plain white sneakers and clothing you could wear off the clock do not, even if you never actually do. Laundering costs for qualifying uniforms are deductible whether you use a service or wash them yourself.
Medical tools like stethoscopes, diagnostic sets, and penlights are deductible in the year purchased. Most nursing equipment is inexpensive enough to expense in full rather than depreciate.4Internal Revenue Service. Topic No. 704, Depreciation Personal protective equipment your duties require, such as respirator masks, face shields, and goggles, is also deductible. Save the receipts and note the business purpose. Documented purchases look clean in an audit; undocumented ones don’t.
Travel and Mileage
Travel is one of the largest deductions available to self-employed nurses, especially travel nurses. The IRS standard mileage rate for 2026 is 72.5 cents per mile for business driving.5Internal Revenue Service. 2026 Standard Mileage Rates You can use this rate or track actual vehicle expenses (gas, maintenance, insurance), but you have to pick one method for the year.
When an assignment requires you to stay overnight away from your tax home, lodging is fully deductible and meals are 50% deductible.6Internal Revenue Service. Topic No. 511, Business Travel Expenses Your tax home is the city where your main place of business sits, which isn’t always where your family lives. A lot of travel nurses miss that distinction.
The assignment must also be temporary, meaning one year or less. If it extends beyond 12 months, the IRS treats it as indefinite and travel deductions stop.6Internal Revenue Service. Topic No. 511, Business Travel Expenses Travel nurses should also maintain a permanent tax home by keeping a residence they return to. Proof of rent or mortgage payments, a driver’s license and voter registration in your home state, and returning home at least once a year all support the case that an assignment is a temporary leave rather than a move.
Driving between work sites during the day, such as between home health patients, counts as deductible business mileage. Driving from home to a regular workplace is commuting, which is never deductible.
Home Office
If you use a dedicated space in your home regularly and exclusively for your nursing business, such as for scheduling, billing, or charting, you may qualify for the home office deduction. The space cannot double as a guest bedroom or family area.
The simplified method gives you $5 per square foot up to 300 square feet, capped at $1,500.7Internal Revenue Service. Simplified Option for Home Office Deduction The regular method applies the business-use percentage of your home to actual housing costs (mortgage interest or rent, utilities, insurance, repairs). More paperwork, but often a larger deduction if the office is sizable.
W-2 employees can’t claim this deduction, even if they work from home. Self-employed only.
Continuing Education
CE expenses are deductible on Schedule C when the courses maintain or improve skills in your current role, or when state law requires them to keep your license active.8Internal Revenue Service. Topic No. 513, Work-Related Education Expenses Tuition, books, supplies, and travel to mandatory seminars all qualify. Online courses in wound care, pharmacology, or infection control are typical examples.
Education fails the deductibility test in two cases: when the coursework meets the minimum requirements for your current job, or when it qualifies you for a new profession.9Internal Revenue Service. Publication 970 (2025), Tax Benefits for Education – Section: 11. Business Deduction for Work-Related Education The second rule trips up a lot of nurses. An RN pursuing a Nurse Practitioner degree is generally treated as qualifying for a new profession, and an LPN studying to become an RN is in the same boat. Those tuition costs usually aren’t deductible on Schedule C, even though the work is clearly nursing-related. Education credits, covered next, can still help.
Education Credits and Student Loan Interest (Any Nurse)
Two federal education credits are available to W-2 and 1099 nurses alike, which makes them especially useful for employees who can’t deduct education as a business expense.
The American Opportunity Tax Credit covers the first four years of higher education and offers up to $2,500 per eligible student per year, with 40% (up to $1,000) refundable.10Internal Revenue Service. American Opportunity Tax Credit It phases out for single filers with modified adjusted gross income approaching $90,000 and joint filers approaching $180,000.11Internal Revenue Service. Education Credits – AOTC and LLC
The Lifetime Learning Credit is broader. It covers undergraduate, graduate, and professional coursework with no year limit, and equals 20% of the first $10,000 in qualified expenses for a maximum $2,000 per return. It’s non-refundable, so it can zero out your tax but won’t generate a refund alone.12Internal Revenue Service. Lifetime Learning Credit The same MAGI limits apply.11Internal Revenue Service. Education Credits – AOTC and LLC
Nurses repaying student loans can deduct up to $2,500 of interest per year as an adjustment to income, whether or not they itemize. For 2026, the deduction phases out between $85,000 and $100,000 of MAGI for single filers and between $175,000 and $205,000 for joint filers.
Health Insurance Premiums
Self-employed nurses who aren’t eligible for a spouse’s employer health plan can deduct 100% of health insurance premiums as an adjustment to gross income. This covers you, your spouse, dependents, and children under 27 even if they aren’t dependents.13Internal Revenue Service. Instructions for Form 7206 The policy has to be established under your business, either in the business name or in your name as the sole proprietor.
You take this on Schedule 1, not Schedule C. That matters because the deduction reduces income tax but not self-employment tax. It’s also unavailable for any month you were eligible to participate in an employer-subsidized plan, even if you didn’t enroll.13Internal Revenue Service. Instructions for Form 7206
Retirement Contributions
Self-employment opens retirement plans with substantial contribution room. A SEP-IRA lets you contribute up to 25% of net self-employment earnings, capped at $72,000 for 2026, with simple setup and no annual filing until the balance hits a certain threshold.14Internal Revenue Service. SEP Contribution Limits (Including Grandfathered SARSEPs) The contribution is deductible as an adjustment to income.
A solo 401(k) allows similar total room ($72,000 combined for 2026) but with more flexibility: employee deferrals of up to $24,500 plus employer profit-sharing of up to 25% of net self-employment income. Catch-up contributions raise the employee deferral limit at age 50. Solo 401(k)s also permit Roth contributions; SEP-IRAs don’t.
Traditional (pre-tax) contributions reduce taxable income dollar for dollar. If you’re earning steady self-employment income and not contributing, this is one of the largest deductions on the table.
Self-Employment Tax and the QBI Deduction
Independent contractor nurses owe self-employment tax on net earnings, covering both halves of Social Security and Medicare at 15.3% (12.4% Social Security on earnings up to $184,500 in 2026, plus 2.9% Medicare with no cap).15Social Security Administration. Contribution and Benefit Base An additional 0.9% Medicare surtax hits self-employment income above $200,000 ($250,000 joint). You can deduct half your self-employment tax as an adjustment to income on Schedule 1, which reduces income tax though not the self-employment tax itself.3Internal Revenue Service. Instructions for Schedule C (Form 1040)
Self-employed nurses may also deduct up to 20% of their qualified business income under Section 199A, made permanent by the One Big Beautiful Bill Act. The deduction sits on top of Schedule C deductions and doesn’t require itemizing. Healthcare is a “specified service trade or business,” so the deduction phases out at higher incomes: below the annual threshold you get the full 20% of net business income, above it the deduction shrinks and eventually disappears. Check the current year’s inflation-adjusted thresholds when you file. W-2 wages don’t qualify at any income level.16Internal Revenue Service. Qualified Business Income Deduction
Keeping the Records That Make Deductions Stick
Every deduction above depends on documentation. The IRS doesn’t require a specific format, but you need enough to prove each expense was real and business-related. Save receipts showing date, amount, vendor, and item. For mileage, log the date, destination, business purpose, and miles, ideally close to when the trip happened. A spreadsheet or mileage app is fine.
For equipment and supplies, note the business purpose at the time of purchase. “Stethoscope for patient assessments” written on the receipt goes a long way if the IRS asks later. Bank and credit card statements alone usually aren’t enough; they show you spent money but not why. Pair them with receipts, invoices, or a contemporaneous log, and the record holds up.