Private-duty care is care that is not ordered by a physician. These services are usually not covered by insurances. Private-duty services may include skilled nursing, respite time for caregivers, housekeeping, assistance with activities of daily living, and more. These services are billed directly to the patient or the patient’s responsible party. The cost varies by type of service, number of visits, mileage, travel time and so on. The services and the fees involved are discussed with the patient and/or the responsible party and are provided in a written agreement at the time the services begin.