US Nursing Agencies: The Rules Set Your Minimum Pay. How Many Years You Stay, and What You Pay to Leave, Come From the Contract

Published 23 October 2026 · Luke, co-founder of NCLEX BANK · 11 min read

To work as a nurse in the United States, you need a US employer to file a green-card petition (Form I-140) for you. Most nurses look for that employer through an "agency". But the word covers three very different kinds of company, and which lines of the contract matter depends on which one you are talking to. This article separates what the rules decide (the pay floor and the employer's duties) from what is left to the contract (how many years, breach fees and other fees), and checks each point against federal regulations, US government manuals, state laws, court rulings and the recruitment rules of the Philippines, India and Nigeria.

1. "Agency" means three different things. Ask who files your I-140

In US nurse recruitment, at least three kinds of company get called an "agency".

1. The hospital hires you directly
   Your employer is the hospital. The hospital files your I-140 and pays your salary
2. A recruiter places you with a hospital
   Your employer is the hospital the recruiter sends you to. The recruiter is not your employer, so the hospital files the I-140
3. A staffing company hires you and sends you to hospitals
   Your employer is the staffing company. It files the I-140 and pays you, and the hospital where you work is its "client"

All three look like "the agency found me a hospital". In law, the employer is completely different in each, and in a green-card case it is the employer who carries the duties. The federal regulation (8 CFR 204.5(c)) says an EB-3 petition may be filed by "any United States employer desiring and intending to employ" the foreign worker. The USCIS Policy Manual adds that a company which cannot offer full-time, permanent work as the actual employer cannot file. Staffing companies are allowed to be that employer: the manual uses them as an example of an employer whose staff work at several sites.

So the first question is a single one: "Which company files my I-140?" If the answer is the company named on your contract, you are in case 3. If it is a hospital, you are in case 1 or 2.

2. The pay floor: set by the rules, and you can check it yourself

The hourly rate is the first thing anyone reads in an agency offer. Here, the rules draw a floor.

When it files, the employer promises that the wage offered is at least the "prevailing wage" for the area, and that the wage paid when you start work will be at least the prevailing wage at that time (20 CFR 656.10(c)(1)). The Department of Labor sets the prevailing wage for each case at the employer's request. And commissions or bonuses cannot be used to reach the floor: the employer must guarantee at least the prevailing wage, paid weekly, every two weeks or monthly (656.10(c)(2)). However large a sign-on bonus looks, it does not count toward the minimum.

The rules also say which area. According to the USCIS Policy Manual, an employer with several work sites, such as a staffing company, uses the area of the site where you will work if it is known, and the area of its headquarters if it is not.

The numbers behind the prevailing wage are public. In the wage tables the Department of Labor uses from 1 July 2026 to 30 June 2027 (based on the Bureau of Labor Statistics survey of May 2025), the hourly wage for registered nurses (SOC 29-1141) in four large metro areas is as follows. Levels I to IV are four steps set by how much experience and skill the job requires.

• New York metro area: Level I $44.31 ($92,165 a year) / II $50.87 / III $57.44 / IV $64.00
• Los Angeles metro area: Level I $49.61 ($103,189) / II $58.50 / III $67.40 / IV $76.29
• Houston metro area: Level I $36.13 ($75,150) / II $42.14 / III $48.16 / IV $54.17
• Chicago metro area: Level I $36.40 ($75,712) / II $41.71 / III $47.03 / IV $52.34

Annual figures are the hourly wage times 2,080 hours, as the Department of Labor calculates them. The New York metro area covers the five boroughs of New York City, Long Island (Nassau and Suffolk), surrounding counties such as Westchester, and northern New Jersey. For the same job, Level I in Los Angeles is more than $13 an hour above Level I in Houston. An hourly rate means little until you know which area it belongs to.

To look it up yourself, open the Wage Search on flag.dol.gov, choose "Registered Nurses (29-1141)" as the occupation and the place you will work as the area.

One more thing: the job has to be announced on a notice at the workplace. The employer puts it up 30 to 180 days ahead of filing the I-140, for at least 10 consecutive business days, where employees can see it (20 CFR 656.10(d)). For Schedule A cases the notice must give a description of the job and the rate of pay (656.10(d)(6)), and USCIS says the wage on it must be at least the prevailing wage at the time of posting, or, if a range is given, that the bottom of the range must be. A staffing company posts it at every client site where people in the same occupation are placed. Your wage is a number that has already been written down once, there.

3. Fees: what US rules forbid, and what the Philippines, India and Nigeria say

On money paid to agencies, US rules and the rules of your home country draw separate lines.

US rules forbid the employer to receive payment of any kind for obtaining the labor certification, including the employer's attorneys' fees (20 CFR 656.12(b)). Deductions from your pay count as receiving it (more in section 8 of our green-card article). On the other hand, the State Department's manual says it is permissible for you to pay a recruiter or other third party to secure a job with a US employer, provided you are not paying for the labor certification (the manual's example is a worker and an employer who share one lawyer) (9 FAM 502.4-4). In US immigration procedure, a placement fee as such is not banned.

What your home country says depends on where you are leaving from.

Philippines: on an immigrant visa you are an emigrant, not an OFW

This is the point many Filipino nurses miss. The Department of Migrant Workers' 2023 rules define an overseas Filipino worker (OFW) as someone working in a country "of which he or she is not an immigrant". If you leave on an EB-3 immigrant visa, you are going to become a permanent resident, so you fall outside that definition. A 2004 POEA circular (MC No. 13, s. 2004) still sets the route: holders of employment-based immigrant visas are not processed by the POEA (now the DMW); they attend the pre-departure seminar of the Commission on Filipinos Overseas (CFO) and get its clearance. The CFO's 2026 Citizen's Charter still asks US-bound emigrants holding EB-3 visa codes (E31, E32, EW3) for their contract.

• The DMW's protections are written for OFWs: a placement fee of no more than one month's basic salary (2023 rules, section 56), no bond or cash deposit to guarantee the contract (section 163), and no illegal exaction "including salary deduction". Whether they reach an EB-3 immigrant is not clear from the rules, so do not assume they protect you
• The US is a no-placement-fee destination only for H-2B workers (POEA Advisory No. 19, 2010), not for immigrant visas
• The same 2004 circular says the agency still licenses immigration consultancies that recruit and registers US employers of immigrant workers. You can check a company's licence on the DMW's list of licensed recruitment agencies (dmw.gov.ph)

India: a ₹30,000 cap, and a register of licensed agents

India's Emigration Act 1983 covers recruitment for work "in any country or place outside India", and a recruiting agent needs a certificate from the Ministry of External Affairs (section 10). The ministry's advisory of December 2023 says no recruiting agent may collect service charges of more than ₹30,000 plus 18% GST, and the agent must give a receipt. Emigration clearance on eMigrate, though, applies only to ECR passport holders going to 19 ECR countries, and the US is not one of them. We found no ministry statement on how the cap is enforced for US-bound recruitment. You can check an agent under "Verify RA Status" on emigrate.gov.in; the ministry says 3,505 illegal agents had been flagged there by April 2026.

Nigeria: a licence is required, a fee cap is not written down

Nigeria's Labour Act says no one may recruit a citizen for work "in Nigeria or elsewhere" without an employer's permit or a recruiter's licence (section 23), and the minister licenses recruiters for work abroad (section 25). The Act lets the minister set a scale of fees (section 71), but we found no regulation that does. The Nigeria Code of Conduct for Private Employment Agencies says agencies shall not charge job seekers any fees, but it is a code, not a statute. Registered agencies are listed on the labour ministry's NELEX portal (nelex.gov.ng).

Nigeria is also on the WHO Health Workforce Support and Safeguards List (2023). WHO recommends that employers and recruiting agencies refrain from actively recruiting health workers from listed countries. It is voluntary, and applying for a job yourself or moving under a government-to-government agreement is not covered. A 2026 update is under way, and WHO's March 2026 briefing still counts Nigeria among the countries that meet the criteria.

4. How many years: the contract decides, not the rules

Agency contracts usually say "you will work for this employer for so many years". Where does that number come from?

What the rules require is that you intend to take the job when you enter the country. The State Department's manual (9 FAM 302.1-5) says that an immigrant whose visa is based on a job offer must go to the job in the petition promptly, and tells consular officers to have applicants sign a statement to the effect that they intend to start that job with that employer soon after arrival. Someone who cannot or will not take the job cannot get the visa.

But a required number of years appears nowhere in the federal regulations, the USCIS Policy Manual or the State Department manual we checked. Two years, three years: those numbers come from the contract.

There is a "portability" rule that lets green-card applicants change employers (INA section 204(j)), but it is for people inside the US whose application to adjust status (Form I-485) has been pending for 180 days or more. It does not apply to nurses who receive an immigrant visa at a US embassy abroad and enter on it.

5. Breach fees: courts and states are drawing lines

Some agency contracts say that if you leave before the agreed period, you pay a set amount. In English contracts it is called liquidated damages, a breach fee or a promissory note. In the past few years, US courts and state legislatures have started to rule on these clauses in plain terms.

The two rulings both come from the federal district court for the Eastern District of New York, in cases brought by nurses from the Philippines against the staffing companies that employed them.

• Paguirigan (24 September 2019): a three-year contract with $25,000 to pay for leaving in the first year ($16,666.67 in the second, $8,333.34 in the third). The court held it was a penalty, not a reasonable estimate of the employer's loss, and that the company had violated the forced-labour provision of the federal Trafficking Victims Protection Act (TVPA), which counts "serious harm" through financial pressure. In September 2020 the appeals court affirmed the declaration that the clause was void and the injunction; it did not rule on the trafficking finding
• Magtoles (30 March 2023): a 6,000-hour commitment with $15 for every hour not worked, up to $90,000. A nurse who left after 2,000 hours would owe $60,000. The court declared the clause, and a three-year nationwide non-compete, unenforceable, and held the company and its owner liable under the TVPA

The cases have kept coming since. In 2024 the same court refused to dismiss the Department of Labor's claim that a staffing company's quit fees were an illegal "kick-back" under the federal wage law, and in May 2025 New York's Attorney General recovered $663,668.66 for 71 nurses from the same companies over a fee of up to $20,000. In March 2025 an Ohio federal court approved a class settlement with Health Carousel worth $6.05 million, plus about $8.3 million of disputed breach debt written off. And in 2026, courts in Tennessee (April) and Texas (July) refused to dismiss trafficking claims from foreign-trained nurses who said they faced exit fees of more than $40,000, and of $25,000 to $150,000. Settlements and early rulings like these are not findings that a fee was illegal, but they show where the claims are going.

The TVPA (18 U.S.C. 1589) says outright that "serious harm" includes financial harm, and people harmed can sue for damages and lawyers' fees (section 1595). Holding on to someone's passport in connection with forced labour is a crime in itself (section 1592).

State laws are moving too.

• California (AB 692): bans contract terms that make a worker pay a penalty, fee or cost for leaving, and the law's definition expressly includes reimbursement of immigration or visa costs and liquidated damages. It was due to cover contracts from 1 January 2026, but a follow-up law signed on 30 September 2026 (AB 1697) moved the start to contracts made on or after 1 January 2027. Exceptions include a sign-on bonus in a separate agreement repaid pro rata over no more than two years. An employer in breach pays actual damages or $5,000 per worker, whichever is greater
• New York (Trapped at Work Act): bans making an employment promissory note (a promise to pay if you leave before a set time) a condition of the job, and makes such notes void. It was signed on 19 December 2025 and amended on 13 February 2026, and takes effect one year after it became law: 19 December 2026 by the text, though some law firms read it as 13 February 2027. It does not name immigration costs. Penalties are $1,000 to $5,000 per violation
• Connecticut: from 1 October 2026 its ban on such notes covers all employers (before, only those with 26 or more employees). A separate 2026 act excludes notes for repaying H-1B visa fees paid by the employer, and how the two will read together has not yet been codified

6. Experience and the NCLEX: what no agency can do for you

"How many years of experience do I need?" The answer, again, splits between the rules and the contract. The conditions for a nurse to file under Schedule A (20 CFR 656.5(a)(2)) are one of three: a CGFNS (now TruMerit) certificate, a permanent, full and unrestricted nursing licence in the state where you will work, or a pass on the NCLEX-RN. Years of experience are not on that list. How much experience to ask for is the employer's hiring condition, which is why agencies and hospitals give different answers.

And some things only you can do, whichever agency you work with. Your credential evaluation, the NCLEX, your state licence application and VisaScreen are all filed in your own name. An agency can organise the paperwork and no more. If you file on the strength of an NCLEX pass, the I-140 can only go in after you pass. Your priority date is the day the I-140 is received, so every month your pass slips, your place in the green-card queue slips with it. How the queue works is in section 2 of our green-card article.

Summary

1. "Agency" covers three things: a hospital hiring you directly, a recruiter placing you with a hospital, and a staffing company that employs you and sends you to hospitals. The question that sorts them is "Who files my I-140?"
2. The employer that files must offer full-time, permanent work and show it can pay until your green card
3. Pay has a floor, the prevailing wage, and bonuses do not count toward it. In the 2026–27 tables, Level I for a registered nurse is $44.31 an hour in the New York area and $36.13 in Houston
4. You can look up the prevailing wage yourself on the Department of Labor's Wage Search. The level is decided case by case
5. US rules forbid the employer to take labor-certification costs from you, but do not ban placement fees. A Filipino nurse on an immigrant visa is an emigrant handled by the CFO, so the DMW's one-month cap may not apply; India caps agents at ₹30,000 + GST; Nigeria requires a licence but sets no fee cap in law
6. How many years you work is set by the contract, not the rules. The rules require only that you intend to take the job when you arrive
7. On breach fees, a New York federal court struck down $25,000 (2019) and $15 an hour (2023) and found TVPA violations. California's ban covers contracts from January 2027; New York's starts by early 2027
8. Years of experience are the employer's hiring condition. Passing the NCLEX is something no agency can do for you

Frequently asked questions

Do I need an agency to work as a nurse in the US?

The rules require a US employer that files the green-card petition (Form I-140), not an agency. Only an employer can file an EB-3 I-140 (8 CFR 204.5(c)), and the employer can be either a hospital or a staffing firm which employs nurses and places them in hospitals. Your credential evaluation, the NCLEX, the state licence application and VisaScreen are all filed in your own name, whether or not you use an agency. If you do sign with one, ask first which company will file your I-140: the answer tells you whether it is your employer or only a recruiter.

What is the minimum hourly pay for a foreign nurse in the US?

In a green-card case, the employer promises to pay at least the prevailing wage for the area (20 CFR 656.10(c)(1)). In the Department of Labor's tables for July 2026 to June 2027, Level I for a registered nurse is $44.31 an hour in the New York metro area, $49.61 in Los Angeles, $36.13 in Houston and $36.40 in Chicago. The Department decides which level applies case by case, and bonuses cannot be used to reach the floor. You can look up the figure for any area on flag.dol.gov's Wage Search.

Do I have to pay a breach fee if I leave my US agency contract early?

It depends on the contract and the state law that governs it. A federal court in New York held that a $25,000 fee in Filipino nurses' three-year contracts (2019) and a fee of $15 for every unworked hour, up to $90,000 (2023), were unenforceable penalties and that the companies violated the federal anti-trafficking law (TVPA). California bans contract terms that make workers repay immigration or visa costs when they leave, for contracts made from 1 January 2027, and New York's ban on employment promissory notes takes effect by early 2027. For your own contract, ask a US lawyer.