Taxes / Deductions and credits
What you can actually deduct
Online lists of nurse write-offs mostly ignore one fact: since 2018, most W-2 employees cannot deduct unreimbursed work expenses on a federal return. Who you are paid by changes the answer.
Rules for tax year 2026 unless a line says otherwise. Written November 2, 2026.
For general information only. This is not tax, legal or financial advice, and we are not your tax preparer. Rules change and your facts decide how they apply, so consult a qualified tax professional before you act on it.
If you are a W-2 employee
Federal deductions for unreimbursed employee expenses have been suspended for tax years beginning after 2017. Only a few groups can still use Form 2106: Armed Forces reservists, qualified performing artists, fee-basis government officials and people with impairment-related work expenses.
Your real options are getting the employer to pay through an accountable plan, the education credit if you qualify, and your state. Some states still allow employee expenses on their own return, so check yours.
Item by item
License, certification and renewal fees
Who can claim it: A 1099 clinician, for the work they are in business doing. A W-2 employee generally has no federal deduction.
Tax year: The year you pay it. Federal rules checked for 2025 and 2026.
If reimbursed: If the employer repays you under an accountable plan, it is not income and you cannot also deduct it.
Limits: A first license that qualifies you for a new kind of work is treated differently from renewing one you hold.
Records: Receipt, license number, what it was for.
Continuing education
Who can claim it: A 1099 clinician, when it maintains or improves skills in their current work. Anyone with a Form 1098-T from an eligible school may look at the lifetime learning credit, W-2 included.
Tax year: The credit figures here are for 2025 returns: it phases out between $80,000 and $90,000 of modified adjusted gross income, or $160,000 to $180,000 joint.
If reimbursed: Employer education assistance up to $5,250 a year can be excluded from income, and you cannot also claim what it paid for.
Limits: Education that qualifies you for a new trade is not deductible as a business expense, even if it helps you at work. Many CE vendors do not issue a 1098-T.
Records: Course certificate, receipt, Form 1098-T if any.
Uniforms, boots and equipment
Who can claim it: A 1099 clinician, when ordinary and necessary for the work. A W-2 employee generally has no federal deduction.
Tax year: Generally the year you buy it. Costlier items can have other rules.
If reimbursed: Ask for an employer reimbursement or allowance. A plain allowance with no paperwork is taxable wages.
Limits: Clothing you could wear anywhere is a weak claim. Ask a preparer before counting scrubs or boots.
Records: Receipt and what the item was for.
Mileage
Who can claim it: A 1099 clinician, for business miles. A W-2 employee generally has no federal deduction.
Tax year: 2026: 72.5 cents per business mile through June 30, 76 cents from July 1. Other years have other rates.
If reimbursed: An employer may repay mileage under an accountable plan. You cannot deduct what was repaid.
Limits: Driving between home and your regular workplace is personal commuting, however far it is.
Records: Date, miles, destination and business purpose, written close to the trip.
Travel, lodging and meals
Who can claim it: A 1099 clinician traveling away from a real tax home. A W-2 employee is limited to accountable-plan reimbursement.
Tax year: Publication 463, 2025 edition. Meals are generally 50% deductible.
If reimbursed: Allowances under an accountable plan are not wages. Anything above what the plan allows can be.
Limits: No tax home means no travel deduction. An assignment expected to run over a year is not temporary. Days at home are not away-from-home days.
Records: Dates, place, business purpose and amounts. See the assignment calendar.