Category guide
Home Care Agency Licensure Requirements, by State
Last reviewed: July 24, 2026
There is no federal home care license — every state sets its own licensing framework, from single-license systems covering all home care to states that still don’t license non-medical agencies at all. Medicare certification (42 CFR Part 484) sits on top for agencies billing Medicare.
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Reviewed quarterly by Vitable Health.
Federal baseline (applies in every state)
Federal
No federal home care license. There is no federal license for home care or home health agencies. Licensure is a state function: each state (and DC) decides whether and how to license home health agencies and non-medical personal care/companion agencies, so requirements vary dramatically by jurisdiction.
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Medicare certification (42 CFR Part 484). Agencies that bill Medicare for skilled home health must be certified as meeting the Medicare Conditions of Participation at 42 CFR Part 484 (patient rights, comprehensive assessment, QAPI, skilled professional services, home health aide standards, and more), on top of any state license.
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Accreditation with deemed status. Most new Medicare home health agencies obtain certification through a CMS-approved accrediting organization with deeming authority — ACHC, CHAP, or The Joint Commission — whose surveys substitute for the state agency's Medicare certification survey.
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State survey agencies enforce both. State survey agencies (usually the state health department) operate under agreements with CMS to survey Medicare-certified agencies, and most also run the state licensure survey program — initial surveys, renewal/recertification surveys, complaint investigations, and plan-of-correction enforcement per the CMS State Operations Manual.
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Every state at a glance
| State | Licensing agency | Governing rule | License type |
|---|---|---|---|
| Alabama | ADPH (survey) / SHPDA (CON) | Ala. Code § 22-21-260 et seq. (CON); no licensure statute | None — CON + Medicare certification (home health); none for non-medical |
| Alaska | AK Dept. of Health | AS 47.32; 7 AAC 12 | Home health agency; none for non-medical |
| Arizona | AZ Dept. of Health Services | A.R.S. §§ 36-151, 36-425.01 | Home health agency; none for non-medical |
| Arkansas | AR Dept. of Health | Ark. Code Ann. tit. 20, ch. 10; ADH rules | Home health agency; Private care agency (non-medical) |
| California | CDSS (non-medical) / CDPH (home health) | Cal. HSC §§ 1796.10 et seq.; 1725 et seq. | Home Care Organization; Home health agency |
| Colorado | CDPHE | C.R.S. § 25-27.5-101; 6 CCR 1011-1 ch. 26 | Home care agency Class A (skilled) / Class B (non-medical) |
| Connecticut | CT DPH / CT DCP | C.G.S. § 19a-490; § 20-670 | Home health agency; Homemaker-companion agency registration |
| Delaware | DE Division of Health Care Quality | 16 Del. C. ch. 11; 16 DE Admin. Code 3345 | Home health agency; Personal Assistance Services Agency |
| District of Columbia | DC Health (HRLA) | D.C. Code § 44-501; 22-B DCMR ch. 39 | Home care agency |
| Florida | FL AHCA | Fla. Stat. ch. 400 pt. III; ch. 408 pt. II | Home health agency; Nurse registry; Homemaker/companion registration |
| Georgia | GA DCH (HFRD) | O.C.G.A. § 31-7-300; Ga. R. 111-8-65 | Private home care provider; Home health agency (CON) |
| Hawaii | HI DOH (OHCA) | HRS ch. 321; HAR ch. 11-700 | Home care agency; Home health agency |
| Idaho | ID Dept. of Health & Welfare | Streamlined Facilities Licensing Act (2025) | None (non-medical); Medicare certification (home health) |
| Illinois | IL Dept. of Public Health | 210 ILCS 55; 77 Ill. Adm. Code 245 | Home services agency (non-medical); Home health agency |
| Indiana | IN Dept. of Health | IC 16-27-1; IC 16-27-4 | Home health agency; Personal services agency |
| Iowa | IA DIAL (survey agency only) | No licensure statute | None; Medicare certification only |
| Kansas | KDHE | K.S.A. 65-5101 et seq.; K.A.R. 28-51 | Home health agency (incl. supportive care) |
| Kentucky | KY CHFS (OIG) | KRS 216B; KRS 216.710; 906 KAR 1:180 | Home health agency (CON); Personal services agency cert. |
| Louisiana | LDH Health Standards | La. R.S. 40:2116.31; 40:2120.1 | Home health agency; HCBS provider (PCA modules) |
| Maine | ME DHHS (DLC) | 22 M.R.S. ch. 419; § 1717 | Home health license; Personal care agency license |
| Maryland | MD OHCQ | Md. Health-Gen. § 19-4A; COMAR 10.07.05 | Residential Service Agency; Home health agency (CON) |
| Massachusetts | MA EOHHS (proposed) / DPH (survey) | No licensure statute (H.4706 pending) | None yet — non-medical licensure bill pending; no HHA license |
| Michigan | MI LARA (survey agency only) | No licensure statute | None; Medicare certification only |
| Minnesota | MN Dept. of Health | Minn. Stat. §§ 144A.43-.4799 | Home care license — basic / comprehensive |
| Mississippi | MS State Dept. of Health | Miss. Code Ann. § 41-71-1 | Home health agency (CON; moratorium struck down 2026); none for non-medical |
| Missouri | MO DHSS | §§ 197.400-.477 RSMo; 19 CSR 30-26 | Home health agency; none for non-medical |
| Montana | MT DPHHS | Mont. Code Ann. § 50-5-101 | Home health agency; none for non-medical |
| Nebraska | NE DHHS | Neb. Rev. Stat. § 71-401; 175 NAC 14 | Home health agency; no distinct non-medical license |
| Nevada | NV DPBH (HCQC) | NRS chs. 449, 449B; NAC 449 | Personal care services agency; Home health agency |
| New Hampshire | NH DHHS (HFA) | RSA 151; He-P 809 | Home health care provider (incl. personal care) |
| New Jersey | NJ Consumer Affairs / NJ DOH | N.J.S.A. 34:8-45.1; N.J.A.C. 8:42 | Health care service firm registration (+accreditation); HHA license (CON) |
| New Mexico | NM Health Care Authority (DHI) | 8.370.22 NMAC (2024) | Home health agency; personal care via Medicaid rules |
| New York | NYS DOH / PHHPC | PHL art. 36, § 3605; 10 NYCRR 766 | LHCSA; CHHA (certified) |
| North Carolina | NC DHSR | N.C.G.S. § 131E-135; 10A NCAC 13J | Home care agency; Home health (CON) |
| North Dakota | ND HHS | N.D.C.C. ch. 23-17.3 | Home health agency; none for non-medical |
| Ohio | OH Dept. of Health | R.C. ch. 3740 (HB 110) | Skilled home health; Nonmedical home health services |
| Oklahoma | OK State Dept. of Health | 63 O.S. § 1-1960; OAC 310:662 | Home care agency (skilled and personal care) |
| Oregon | OR Health Authority | ORS 443.305; OAR 333-536 | In-home care agency; Home health agency |
| Pennsylvania | PA Dept. of Health | 28 Pa. Code chs. 611, 601 | Home care agency/registry; Home health care agency |
| Rhode Island | RI Dept. of Health | R.I. Gen. Laws ch. 23-17; 216-RICR-40-10 | Home care provider; Home nursing care provider (both require CON) |
| South Carolina | SC Dept. of Public Health | S.C. Code § 44-70-10; Reg. 61-122 | In-home care provider; Home health agency (CON) |
| South Dakota | SD Dept. of Health | SDCL Title 34 (HB 1138 vetoed 2026) | None (non-medical); Medicare certification (home health) |
| Tennessee | TN Health Facilities Commission / TDMHSAS (PSSA) | Tenn. Code Ann. § 68-11-201; tit. 33 (PSSA) | Personal support services agency; Home health agency (CON) |
| Texas | TX HHSC | Tex. H&S Code ch. 142; 26 TAC 558 | HCSSA — PAS / LHH / L&CHH / Hospice |
| Utah | UT DHHS (DLBC) | Utah Admin. Code R432-725 | Personal care agency; Home health agency |
| Vermont | VT DAIL | DAIL HHA designation regs | Designated home health agency; none for non-medical |
| Virginia | VA Dept. of Health (OLC) | Va. Code § 32.1-162.7; 12VAC5-381 | Home care organization (personal care/nursing) |
| Washington | WA Dept. of Health | RCW 70.127; WAC 246-335 | In-home services agency (home care / home health categories) |
| West Virginia | WV OHFLAC | W. Va. Code ch. 16; OHFLAC rules | Home health agency (CON); non-medical registration only |
| Wisconsin | WI DHS (DQA) | Wis. Stat. § 50.49; DHS 133 | Home health agency; Medicaid PCA certification only |
| Wyoming | WY Dept. of Health (HLS) | Wyo. Stat. § 35-2-901 | Home health agency; none for non-medical |
Click any state for the full requirements with citations.