Key points
- The national average fee per regular employment placement in FY2023 was ¥639,000 for nursing, ¥551,000 for long-term care, ¥646,000 for childcare and ¥824,000 for physicians (MHLW, published September 2025).
- Actual fee rates for FY2024 (simple average across placement offices) were 24.0% for all occupations, 21.6% for nursing and 20.2% for long-term care.
- Looking at each placement office's fee rate against its turnover rate within 6 months, MHLW states that "no large difference in turnover rates was seen between offices with higher and lower actual fee rates".
- In a 2025 survey, 75.2% of hospitals said fees for fee-charging job placement were "a heavy burden on management, and high". Most hospitals that had early departures received a refund, but the most common refund amount was "less than 25% of the fee".
- Since April 1, 2025, placement agencies must publish their actual fee rates by occupation and disclose any penalty (cancellation) terms in advance.
All figures come from MHLW publications and surveys. Because surveys differ in whether they report averages or medians, and in who responded (employers or placement agencies), we do not compare figures across years or surveys.
Recruitment agencies (fee-charging job placement（有料職業紹介）) are a reliable way to fill a sudden vacancy, but employers often complain that "the fees are high" or "the person quit right away". In recent years the Ministry of Health, Labour and Welfare (MHLW)（厚生労働省）has started publishing data on placement fees and turnover. Based on that published data, this guide sets out typical fee levels and how to think about them.
01Average fees by occupation (MHLW data)
In September 2025, MHLW published the average placement fee per regular employment placement（常用就職）— a hire on an open-ended contract, or on a fixed-term contract of 4 months or more — for FY2023, broken down by occupation in the medical, long-term care and childcare fields.
- Physicians¥824,000
- Childcare¥646,000
- Nursing¥639,000
- Long-term care¥551,000
The same document also gives figures by regional block. For nursing, fees are highest in Hokuriku (¥740,000) and Tokai (¥723,000), and lowest in Northern Kanto/Koshin (¥472,000) and Kyushu (¥508,000). Note, however, that the blocks are based on where the placement office is located, not where the hiring facility is.
02Fee rates: around 20% of annual pay
Since April 2025, placement agencies have had to post their actual fee rates by occupation on MHLW's Human Resource Services Comprehensive Site（人材サービス総合サイト）. MHLW compiled those postings (FY2024 results, as of the end of October 2025), with the following results.
| Occupation | Average fee rate | Share of offices at 20.1–30.0% | Average turnover within 6 months |
|---|---|---|---|
| All occupations | 24.0% | 42.5% | 7.9% |
| Nursing | 21.6% | 77.5% | 10.5% |
| Long-term care | 20.2% | 71.8% | 15.3% |
| Childcare | 24.3% | 78.2% | 12.2% |
| Physicians | 22.0% | 48.8% | 3.0% |
| General office, secretarial and reception | 24.1% | 65.1% | 4.4% |
| Sales | 31.2% | 17.7% | 5.4% |
In the medical, long-term care and childcare fields, 70–80% of offices set their fee rate in the 20% range. A separate MHLW survey of placement agencies (conducted July–October 2025) also found median fee rates of 20% for registered nurses and licensed practical nurses, 20% for care workers, and 25% for nursery teachers (hoikushi and hoiku kyoyu).
03How fees are set: capped vs. notified
- Capped fees（上限制手数料）: the maximum amount is set by ministerial ordinance. Since October 2019, the cap is set at 11.0% of wages paid (10.3% for tax-exempt businesses), among other limits.
- Notified fees（届出制手数料）: the agency files a fee schedule with the authorities and charges according to it. Rates such as "○% of annual pay" fall under this type. Of private placement agencies' fee revenue in FY2024 (about ¥983.5 billion), 99.7% was under notified fee schedules (our calculation).
04Do higher fees mean better retention?
It's tempting to think that paying a higher fee brings in better people who stay longer, but the published data do not support this. MHLW plotted each placement office's fee rate against its turnover rate within 6 months (nursing n=319, long-term care n=453, childcare n=99, physicians n=91) and concluded that "no large difference in turnover rates was seen between offices with higher and lower actual fee rates".
A difference in turnover by channel is not necessarily an "effect" of the channel
In a 2019 MHLW survey, the turnover rate within 6 months for registered nurses and licensed practical nurses hired through agencies was 23.1%, compared with 12.0% for other channels. However, this gap may also reflect differences in the circumstances of the people hired and of the facilities that use agencies, so it cannot be said that the agency channel itself increases turnover.
05Early departures and refunds in practice
A 2025 MHLW survey (research on employment intermediary businesses in medical and related fields) produced the following results.
75.2%
Hospitals that said fees for fee-charging job placement were "a heavy burden on management, and high"
84.6%
Of hospitals that cited departures within 6 months as a problem, the share that received a refund
37.7%
Hospitals whose refund was "less than 25% of the fee" — the most common amount
53.5%
Hospitals where the post was left vacant after an early departure
How burdensome fees feel varies widely by industry. To the same question, 76.7% in long-term care and 68.2% of pharmacies answered "high", compared with 27.5% in information and communications and 18.6% in retail. The top problem hospitals reported with agencies was "early departure of the person hired (within 6 months)" at 42.8%, followed by "a mismatch discovered after hiring" at 29.9%. Even with a refund, you are still left with the vacancy and the work of hiring again.
06Regulatory timeline (2021–2026)
Encouraging people to apply by offering money beyond what is socially reasonable, such as an "employment congratulatory bonus"（就職お祝い金）, is prohibited
Special consultation desks for employers in the medical, long-term care and childcare fields set up at the Prefectural Labor Bureau（労働局）in every prefecture
Placement agencies required to publish actual fee rates by occupation and to disclose penalty (cancellation) terms in advance. Offering money etc. to job seekers via job sites and the like is also prohibited in principle
"Using a certified appropriate placement agency（適正認定事業者）" became one of the requirements for special exceptions to staffing standards in medical and long-term care (according to industry association materials; we have not checked the original public notice or circular)
07Numbers to check when comparing agencies
On MHLW's Human Resource Services Comprehensive Site, you can search placement offices by region, occupation and fee rate, sort them by fee rate, and see past numbers of placements and of people who left within 6 months. Before signing a contract, it helps to check the following.
- Actual fee rates by occupation (posted on the Human Resource Services Comprehensive Site)
- Number of people who left within 6 months (same site)
- Refund terms (which departure periods are covered, and what share is refunded)
- Whether there are penalty (cancellation) terms, and what they say (advance disclosure required since April 2025)
- Whether the agency is a certified appropriate placement agency for the medical, long-term care and childcare fields
If a dispute arises, you can consult the special consultation desk at your Prefectural Labor Bureau.
08Combining hiring channels
According to the 2025 (Reiwa 7) Survey on Employment Trends（雇用動向調査）, people who joined workplaces in medical care and welfare in 2025 came through advertising (22.1%), Hello Work (Japan's public employment service offices) (20.0%), personal connections (20.0%), schools (11.3%) and private placement agencies (9.8%). Agencies are just one channel, and many workplaces likely combine several — job ads, Hello Work, referrals from staff, their own website and so on.
Whatever the channel, the basic way to reduce "this isn't what I expected" after someone starts is to be honest before they join about both the good and the hard parts of the job. A workplace visit（見学）to see the job in person, or a one-day trial shift（お試し勤務）, is one way to do this (for points to watch when someone actually does work during a trial, see this guide).
Sources
- 地域ブロック別の職種別平均手数料及び離職率についてAverage fees and turnover rates by occupation and regional block
- 職業紹介事業における職種別手数料、離職状況について（資料PDFを含む）Fees and turnover by occupation in the job placement business (including PDF materials)
- 医療等分野における雇用仲介事業に関する調査研究事業 報告書Report of the research project on employment intermediary businesses in medical and related fields
- 令和6年度職業紹介事業報告書の集計結果（速報）Aggregate results of FY2024 (Reiwa 6) job placement business reports (preliminary)
- 医療・介護分野における職業紹介事業に関するアンケート調査 集計結果（概要）Questionnaire survey on job placement businesses in the medical and long-term care fields: summary of results
- 紹介手数料の最高額の改正についてRevision of the maximum placement fee
- 雇用仲介事業者は新たなルールへの対応が必要です（令和7年4月施行）Employment intermediaries must comply with new rules (effective April 2025)
- 「就職お祝い金」などの名目で求職者に金銭等を提供して求職の申し込みの勧奨を行うことを禁止しましたEncouraging job applications by offering job seekers money etc. under names such as "employment congratulatory bonus" is now prohibited
- 『「医療・介護・保育」求人者向け特別相談窓口』を設置しましたSpecial consultation desks for employers in the medical, long-term care and childcare fields have been set up
- 医療・介護・保育分野における適正な有料職業紹介事業者の認定制度Certification system for appropriate fee-charging placement agencies in the medical, long-term care and childcare fields
- 令和7年雇用動向調査結果の概況Overview of the 2025 (Reiwa 7) Survey on Employment Trends
This article is a general explanation based on Japanese laws and public sources as of Sept 25, 2026. Rules change. For individual cases, check with the Prefectural Labor Bureau (労働局), Labor Standards Inspection Office (労働基準監督署), Hello Work, or a licensed labor and social security attorney (社会保険労務士). Sources are mostly in Japanese.