Short answer: yes, recruiters are paid for recruiting people, and the money always comes from the organization that is hiring, not from the person who is hired. An in-house recruiter is paid a salary by the employer. An agency recruiter is paid a share of a placement fee the employer owes when a hire starts, or a share of the margin an agency keeps on every hour a contract clinician works. An ordinary employee who refers a friend may be paid a referral bonus by their own employer. The candidate pays nothing and nothing is deducted from their salary: the largest placement firm's own filing says so, federal rules forbid it for sponsored hires, and the one state statute that still allows an agency to bill the applicant caps the fee and requires a signed contract. The sections below follow the money for each person who might "get money for recruiting", then answer the question hospital talent acquisition leaders usually mean by it: what each of those payments costs them.
Who gets money for recruiting, and who pays it
| Who did the recruiting | Do they get money for it? | Who pays | What the money is |
|---|---|---|---|
| In-house recruiter (hospital, health system, company) | Yes | The employer | A salary, sometimes with a bonus tied to hiring goals; rarely a fee per hire |
| Agency recruiter, permanent placement | Yes, when the hire starts | The employer, through the agency | Base pay plus a share of a placement fee set as a percentage of the hire's first-year pay |
| Agency recruiter, contract and travel staffing | Yes, for every hour on assignment | The facility, through the agency's hourly bill rate | Base pay plus commission from the spread between the bill rate and the clinician's pay |
| An employee who refers a candidate | Sometimes | Their own employer | A one-off referral bonus under the employer's program, paid after the referred person is hired |
| The candidate | No | Nobody | No fee, no deduction; the candidate's salary is set by the employer and paid in full |
Two numbers stay private across the whole table. No staffing firm publishes the share of a fee or a margin its recruiters keep, and no employer is required to publish its referral bonus amount, so this page quotes what the filings and the rules do publish: who owes the money, what it is a percentage of, and who may never be asked for it.
Do recruiters get paid from your salary? No, and the filings say why
The fear behind the question is that an agency's fee is carved out of the hire's pay. For a permanent placement it is not. Robert Half, the largest placement firm by revenue, states in its annual report that "Fees for successful placements are paid only by the employer" and are "generally a percentage of the new employee's annual compensation", and that "No fee for placement services is charged to employment candidates." The fee is calculated from the salary, which is why a recruiter earns more on a $150,000 placement than on a $60,000 one, but it is invoiced to the employer on top of the salary. The firm's placement revenue is "primarily recognized when employment candidates accept offers of permanent employment", and its key drivers are "the number of candidate placements" and the average fee per placement: a count of hires and a fee per hire, never a slice of a paycheck.
Contract and travel staffing is the one model where the recruiter's money and the clinician's pay come out of the same pool, and it still is not a deduction. Robert Half describes it this way: "The contract talent engagement professionals are employees of Robert Half and are paid by Robert Half", while "The customer pays a fixed rate only for hours worked." AMN Healthcare, a nurse, allied and locum tenens staffing company, defines bill rates as "the hourly straight-time rates that we bill to clients" and reports a cost of revenue that "consists predominantly of compensation, benefits, housing, travel and allowance costs for healthcare professionals." The gap between the two is the gross margin, 28.3% in 2025 and 30.8% in 2024 across the company, and 23.0% and 24.5% in nurse and allied staffing. The agency's overhead, profit and the recruiter's commission all come out of that margin. The clinician agreed a pay package, is paid it by the agency, and the facility pays a higher hourly rate than that package; nothing is taken from the package after the fact. If the facility later hires the clinician outright, "The client typically pays a one-time fee for such conversions", again billed to the facility.
Where the law draws the line
For an employer sponsoring a foreign-educated nurse or other worker for a permanent visa, the prohibition is written into federal regulation. Under 20 CFR 656.12, "An employer must not seek or receive payment of any kind for any activity related to obtaining permanent labor certification, including payment of the employer's attorneys' fees", and for that rule "payment includes, but is not limited to, monetary payments; wage concessions, including deductions from wages, salary, or benefits; kickbacks, bribes, or tributes; in kind payments; and free labor." A recruiting arrangement that recovers its cost from a sponsored nurse's wages is therefore not a commercial choice but a violation that can end the certification.
Domestic placement is regulated state by state, and the exception proves the rule. New York still licenses employment agencies that may charge the job applicant, but General Business Law section 185 says such an agency "shall not charge or accept a fee or other consideration unless" it is set in a written contract and the agency's referral actually led to the job, "shall not require or accept a deposit or advance fee from any applicant", and may charge the applicant no more than a gross fee cap that differs by class of work, with nursing in a class of its own. The same section lets the employer "voluntarily assume" the applicant's fee. In practice the healthcare recruiters who contact your candidates are paid under the employer-pays model above; a candidate who is ever asked to sign a fee contract is dealing with a different kind of business, and your recruiters should be able to say so.
Do ordinary employees get money for recruiting people? The referral bonus
When the person asking is not a recruiter but a nurse who referred a classmate, the answer is "if the employer has a program". A referral bonus is an incentive award, not a fee: the employer sets the conditions and the amount, and pays it from its own budget after the referred person is hired. The clearest public statement of how such programs are built is the federal government's own. The Office of Personnel Management's awards guidance says that "Governmentwide awards regulations allow agencies to use the incentive awards authority to establish a referral bonus program that provides incentives to employees who bring new talent into the agency", that "Each agency must determine whether using referral bonuses is appropriate for their agency", and that an agency which creates one "must establish the criteria it will use to determine when an employee would receive a referral bonus."
Three of those criteria answer the question in its narrowest form. Under the federal rules an employee is eligible for a referral bonus only if their official duties do not include recruitment, if they are not "involved in any way in the selection of the referred individual", and if the person referred is not a relative. In other words, the people whose job is recruiting do not get a referral bonus for it; they are paid a salary for it. Hospital referral programs are written by each employer and the amounts are not published in any source this page can quote, but the structure is the same: a bonus is owed to the referrer, by the employer, under written criteria, usually after the new hire has stayed a set number of months.
Is commission required? What the pay data shows
Nothing in federal law requires a recruiter to be paid per hire. The Department of Labor's wages guidance defines a commission as "a sum of money paid to an employee upon completion of a task" and states that "The Fair Labor Standards Act (FLSA) does not require the payment of commissions." Whether a recruiter's money is a flat salary or rises with hires is the employer's choice, and the federal pay survey shows which employers make which choice. 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", about 939,700 jobs in 2025 with 6% growth projected to 2035. The May 2025 medians:
| Human resources specialists, May 2025 | Median annual wage |
|---|---|
| All industries | $75,940 |
| Government (excluding state and local 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. The survey's wages are "straight-time, gross pay", and "incentive pay, including commissions and production bonuses" is included while "nonproduction bonuses" are excluded, so the healthcare row is what a hospital recruiter earns including any per-hire pay, and the agency row is the same for a staffing recruiter. The agency row is the lowest in the table and sits at the bottom of the widest spread in the occupation, which is the shape of a base-plus-commission plan: a few recruiters who place many high-salary candidates, many who place few. The hospital row is a salary that does not move with the count. For the career view, see the salary guide for recruiters; for which recruiters earn commission at all, do recruiters get commission; for the arithmetic of a single placement, how much do recruiters make per hire.
What each payment costs a healthcare employer
Read from the hiring side, the table at the top is a price list. A placement fee is a percentage of the hire's first-year pay, owed per hire, on top of the pay. A travel contract carries the agency's margin on every hour for the length of the assignment. A referral bonus is a fixed sum per referred hire, owed to your own staff. Your in-house recruiters cost the healthcare median above, a salary that stays flat however many clinicians they hire; what limits them is capacity, because finding and messaging passive clinicians one at a time is the work the fees and margins are paying someone else to do.
That capacity gap is what Betterleap is built for. 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 email open rates rise from under 10% to 50-60%. The recruiters are still yours and still salaried; nobody is paid per placement, per hour or per referral. To see what your team could source on its own requisitions, request a demo, and for the playbook, read 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 26 October 2026.
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025 technical notes (what the survey's wages include), read 26 October 2026.
- U.S. Department of Labor, Wages: Commissions, read 26 October 2026.
- U.S. Office of Personnel Management, Can agencies use referral bonuses to support recruitment and hiring? and Who is eligible for a referral bonus?, performance management FAQ, read 26 October 2026.
- U.S. Government Publishing Office, Code of Federal Regulations, 20 CFR 656.12, Improper commerce and payment, 2025 edition, read 26 October 2026.
- New York State Senate, General Business Law section 185, Fees charged by employment agencies, current text, read 26 October 2026.
- Robert Half Inc., Form 10-K for the year ended 31 December 2025, filed 13 February 2026, read 26 October 2026.
- AMN Healthcare Services, Form 10-K for the year ended 31 December 2025, filed 20 February 2026, read 26 October 2026.
- Betterleap: betterleap.com, case studies for Community Health Network and FOX Rehabilitation.
Frequently asked questions
Do recruiters get money for recruiting people?
Yes. An in-house recruiter is paid a salary by the employer, sometimes with a bonus tied to hiring goals. An agency recruiter is paid a share of a placement fee the employer owes when a hire starts, a percentage of the hire's first-year pay, or a share of the margin the agency keeps on every hour a contract clinician works. An employee who refers a candidate may receive a referral bonus from their own employer. In every case the money comes from the organization that is hiring.
Do recruiters get paid from your salary?
No. Placement fees are calculated as a percentage of the new hire's salary but are invoiced to the employer on top of it; Robert Half's annual report states that "Fees for successful placements are paid only by the employer" and that "No fee for placement services is charged to employment candidates." In travel and contract staffing the clinician is paid the agreed package by the agency, and the agency bills the facility a higher hourly rate. Nothing is deducted from the candidate's pay.
Do employees get paid for referring someone who is hired?
Only where the employer runs a referral bonus program, and under its written criteria. The federal government's own rules illustrate the model: an employee may receive a referral bonus for bringing new talent into the agency, provided their official duties do not include recruitment, they were not involved in selecting the referred person, and the person is not a relative. Amounts are set by each employer and are not published in any source this page quotes.
Is it legal for a recruiter to charge the candidate a fee?
For a sponsored permanent visa it is prohibited: 20 CFR 656.12 bars an employer from seeking or receiving "payment of any kind" for the labor certification, including "deductions from wages, salary, or benefits." For ordinary domestic placement it is regulated by state law. New York, for example, allows a licensed employment agency to charge an applicant only under a written contract, with no deposit or advance fee, within a gross fee cap set by class of work. The healthcare recruiters who contact candidates on an employer's behalf are paid by that employer.
How much do recruiters make for recruiting people?
The Bureau of Labor Statistics' May 2025 median for human resources specialists, the occupation that includes recruiters, is $75,940 a year across all industries, $64,130 in healthcare and social assistance and $60,550 in employment services, the staffing and recruiting agencies. Those figures include commissions and production bonuses. The share of a placement fee or a staffing margin that an individual agency recruiter keeps is not published by any firm.