Short answer: some recruiters earn commission and most do not. An in-house recruiter on a hospital's or company's payroll is a salaried employee, sometimes with a bonus tied to hires. An agency recruiter usually earns a base salary plus commission, and that commission is a share of what the agency bills the employer: a placement fee for a permanent hire, or the margin on a contract clinician's hours. Retained executive search firms are paid a retainer whether or not a hire is made, so their consultants are not paid per placement the way contingency recruiters are. The sections below give the pay data, the fee structures the large staffing firms disclose in their own annual reports, and the federal rules that apply once commission is on the table.
Who pays recruiters, and how
| Type of recruiter | Employer | Base pay | Variable pay | What the variable pay depends on |
|---|---|---|---|---|
| In-house (corporate) recruiter | The hiring organization | Salary | Sometimes a bonus | Hiring goals, time to fill, the company's annual bonus plan |
| Agency recruiter, permanent placement | A staffing or search firm | Salary, often lower, or a draw against commission | Commission | Placement fees collected: a percentage of each hire's first-year pay |
| Agency recruiter, contract and travel staffing | A staffing firm | Salary | Commission or bonus | Clinicians on assignment and the hours the agency bills for them |
| Retained search consultant | An executive search firm | Salary | Bonus | Retainers originated and searches completed |
The split between base and commission, and the share of each fee a recruiter keeps, is set by each agency and is not published by any of the firms whose filings we read, so this page does not quote one. What the filings do publish is how the fee itself is calculated, which is what the commission is a slice of.
In-house recruiters are salaried
The Bureau of Labor Statistics counts recruiters inside the occupation "human resources specialists", the people who "recruit, screen, and interview job applicants and place newly hired workers in jobs." Its outlook page puts the occupation at 939,700 jobs in 2025, growing 6% from 2025 to 2035, and gives these May 2025 wages:
| Human resources specialists, May 2025 | Median annual wage |
|---|---|
| All industries | $75,940 |
| Government (excluding education and hospitals) | $84,100 |
| Professional, scientific and technical services | $82,800 |
| Manufacturing | $79,270 |
| Healthcare and social assistance | $64,130 |
| Employment services (staffing and recruiting agencies) | $60,550 |
The lowest-paid 10% earned under $47,180 and the highest-paid 10% over $128,720. Two things to read into that table. First, the wage the survey measures is straight-time gross pay and it already includes "incentive pay, including commissions and production bonuses", while it excludes "nonproduction bonuses" such as a year-end company bonus. So the medians above are what recruiters took home including commission, not a base before it. Second, the employment services row is the agency industry, and its median sits below every other row: agency recruiting pays a lower typical wage with a wider spread, which is what a commission-heavy pay plan looks like in survey data. The healthcare and social assistance row is what a hospital or health system typically pays the recruiters on its own payroll, and nothing in that number depends on how many hires they make.
Agency recruiters earn a share of the placement fee
A recruiting agency is paid by the employer, not the candidate, and only when a hire is made. Robert Half describes its permanent placement business this way in its annual report: "Fees for successful placements are paid only by the employer and are generally a percentage of the new employee's annual compensation. No fee for placement services is charged to employment candidates." Its revenue from that business, it adds, is driven by "the number of candidate placements and average fees earned per placement." A contingency recruiter's commission inherits exactly those two drivers: how many placements start, and how large each fee is.
How large the fee is depends on the model. Heidrick & Struggles, a retained firm, explains the two in its filing: "Executive search firms are generally separated into two broad categories: retained search and contingency search." Retained firms "are paid a retainer for their services equal to approximately one-third of the estimated first year compensation for the position to be filled", and may bill a further one-third of any excess if the hire's actual pay comes in higher. "In contrast, contingency search firms are compensated only upon successfully placing a recommended candidate." Korn Ferry's filing says the same of its own fees: "generally one-third of the estimated first-year cash compensation of the placed candidate, plus a percentage of the fee to cover indirect engagement-related expenses", with an "uptick fee" when the final compensation exceeds the estimate. Contingency fees for non-executive roles are negotiated per client and none of the firms publishes a schedule, so treat any specific percentage you read elsewhere as that agency's quote, not an industry figure.
In practice an agency recruiter on a contingency desk is paid a base salary (or a draw that is recovered from future commission) plus a percentage of each fee the agency collects. Because the fee is a percentage of first-year pay, the commission on a $150,000 placement is worth more than on a $60,000 one, which is one reason agency desks concentrate on higher-paid roles. Commission is normally paid when the fee is collected, after the hire starts, and many placement agreements carry a guarantee period during which a fee is refunded or credited if the hire leaves; ask for those terms before signing.
Healthcare: where the commission comes from
Healthcare recruiting agencies are mostly not permanent placement businesses. The American Staffing Association lists the industry's services as "predominantly temporary and contract staffing, recruiting and permanent placement, outsourcing and outplacement, human resource consulting", and counts nearly 2.2 million temporary and contract employees working for staffing companies in an average week of 2024. AMN Healthcare, a nurse, allied and locum tenens staffing company, says its revenue "primarily consists of fees earned from the temporary staffing and permanent placement of healthcare professionals, executives, and leaders", and that its cost of revenue "consists predominantly of compensation, benefits, housing, travel and allowance costs for healthcare professionals". Its gross profit was 28.3% of revenue in 2025.
That spread, between what the hospital is billed for a travel nurse and what the nurse is paid, is the pool a travel or contract recruiter's commission is drawn from, and it is earned for as long as the clinician stays on assignment. A permanent placement desk inside the same agency, for physicians, executives or international nurses, is paid the fee-per-hire way described above. Either way the recruiter's incentive is a clinician who starts and stays with the agency's client, not a pipeline you own.
The rules that apply once commission is paid
- Commission is optional, by law. The Department of Labor's wages guidance defines a commission as "a sum of money paid to an employee upon completion of a task, usually selling a certain amount of goods or services" and states that "the Fair Labor Standards Act (FLSA) does not require the payment of commissions." A recruiter's commission plan is a contract between the recruiter and the agency.
- Commission counts toward overtime for nonexempt staff. Wage and Hour Division Fact Sheet #56A says earnings "may be determined on a piece-rate, salary, commission, or some other basis, but in all such cases the overtime pay due must be computed on the basis of the average hourly rate derived from such earnings." A bonus promised in advance (a nondiscretionary bonus) is included in that regular rate too; only a bonus whose existence and amount are "at the sole discretion of the employer at or near the end of the period" can be left out. Whether a given recruiter is exempt from overtime is a separate question that turns on duties and salary, not on the job title.
- Commission is withheld as supplemental wages. IRS Publication 15 (2026) lists "commissions, bonuses, awards, prizes" among supplemental wages. When paid separately from regular wages, federal income tax may be withheld at a flat 22%, and at 37% on supplemental wages above $1 million in a calendar year. Commission is ordinary taxable income; it is not taxed at a different rate when the return is filed.
What this means if you run a healthcare talent acquisition team
The question behind "do recruiters get commission" is usually a budget question: what does a hire cost through an agency, and what does it cost through your own team? The filings above answer the first part. An agency fee is a percentage of the hire's first-year pay, so it scales with salary, is owed per placement, and funds a commission that rewards the agency's recruiter for the placement, not for the health of your pipeline. A travel contract carries the agency's margin for every hour of the assignment.
Your own recruiters are paid a salary (the healthcare and social assistance median above), so their cost does not rise with the number of hires. The constraint on an in-house team is capacity: sourcing passive clinicians one at a time is the work that agencies are paid to absorb. That is the gap Betterleap is built to close. The agent searches 35M+ healthcare professionals, checks licensure through 25+ state board partnerships, drafts a personalized outreach sequence, sends it from the recruiter's own mailbox and follows up until the candidate replies, then re-engages the past applicants and silver medalists already in your ATS (25+ integrations). Community Health Network reported a 35% increase in sourcing efficiency and about ten hours a week saved per recruiter; FOX Rehabilitation saw a 60% email open rate against 10% with its CRM; NKCH attributes 20% of its new hires to candidates sourced through Betterleap. None of that carries a per-placement fee. If you want to see what your salaried team could source on its own roles, request a demo. For the recruiter's side of the pay question, see the salary guide for recruiters, and for the sourcing playbook itself, how to source passive nurse candidates.
Sources
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook: Human Resources Specialists, May 2025 wages and 2025-35 projections, read 2 October 2026.
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025 technical notes (what the survey's wages include), read 2 October 2026.
- U.S. Department of Labor, Wages: Commissions, read 2 October 2026.
- U.S. Department of Labor, Wage and Hour Division, Fact Sheet #56A: The Regular Rate of Pay, December 2019, read 2 October 2026.
- Internal Revenue Service, Publication 15 (2026), Employer's Tax Guide, supplemental wages, read 2 October 2026.
- Robert Half Inc., Form 10-K for the year ended 31 December 2025, filed 13 February 2026, read 2 October 2026.
- Korn Ferry, Form 10-K for the fiscal year ended 30 April 2026, filed 26 June 2026, read 2 October 2026.
- Heidrick & Struggles International, Form 10-K for the year ended 31 December 2024, filed 3 March 2025, read 2 October 2026.
- AMN Healthcare Services, Form 10-K for the year ended 31 December 2025, filed 20 February 2026, read 2 October 2026.
- American Staffing Association, Staffing Industry Statistics, 2024 figures, read 2 October 2026.
- Betterleap: betterleap.com, case studies for Community Health Network and FOX Rehabilitation.
Frequently asked questions
Do in-house recruiters get commission?
Usually not. A recruiter employed by the hiring organization is a salaried human resources specialist, sometimes with a bonus tied to hiring goals or the company's annual plan. The Bureau of Labor Statistics' May 2025 median for the occupation is $75,940 a year across all industries and $64,130 in healthcare and social assistance, figures that already include any commission or production bonus paid.
How much commission does an agency recruiter make per placement?
A share of the placement fee, on top of a base salary or draw. The fee is what the firms disclose: Robert Half says its fees are "generally a percentage of the new employee's annual compensation", and retained executive search firms such as Korn Ferry and Heidrick & Struggles charge about one-third of estimated first-year compensation. The percentage of that fee the recruiter keeps is set by each agency and is not published.
Do healthcare recruiters get commission?
Agency healthcare recruiters usually do; hospital recruiters usually do not. Most healthcare staffing revenue is temporary and contract staffing, where the agency's margin between the bill rate and the clinician's pay funds the recruiter's commission for as long as the assignment runs. Permanent placement desks are paid a fee per hire. A recruiter on a hospital's own payroll is salaried.
Is recruiter commission taxed differently from salary?
It is withheld differently, not taxed differently. IRS Publication 15 treats commissions and bonuses as supplemental wages: paid separately from regular wages, they can be withheld at a flat 22% (37% above $1 million in a year). On the tax return, commission is ordinary income like salary.
Does the recruiter's commission come out of the candidate's pay?
No. Placement fees are paid by the employer; Robert Half's filing states that "no fee for placement services is charged to employment candidates." For contract and travel staffing, the clinician is paid by the agency, which bills the hospital a higher rate and keeps the difference as its margin.