Home care licensing requirements by state
Published by Home Care Agency Blueprint. Written under the direction of founder Scott McKenzie. · Updated
All 50 states in one table, taken from the guide’s 50-state summary. Open any state for the full entry, the source notes and conflicts, and the official sources.
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Fees shown as stated in the state entry; see each entry for conditions, conflicts, and sources.
| State | License required? | License / pathway | Fees (initial / renewal) | Flag |
|---|---|---|---|---|
| Alabama | No state license identified | None found; Medicaid waiver personal care via Alabama Medicaid-approved agencies | Not confirmed in official sources — check with the state agency | — |
| Alaska | Medicaid certification only | SDS Personal Care Services / CFC-PCS provider certification | Not confirmed in official sources — check with the state agency | — |
| Arizona | No state license identified | DES/DDD HCBS certification (Medicaid-funded services) | Not confirmed in official sources — check with the state agency | — |
| Arkansas | Yes | ADH Private Care Agency license | $1,000 initial (2021 form); renewal Not confirmed in official sources — check with the state agency | — |
| California | Yes | CDSS Home Care Organization (HCO) license | $5,603 per 2-yr term (initial and renewal) | — |
| Colorado | Yes | CDPHE Home Care Agency license, Class B (non-medical) | Initial Not confirmed in official sources — check with the state agency; FY2026 base renewal $1,545.62 | Changed |
| Connecticut | Yes (registration) | DCP Homemaker-Companion Agency registration | $375 vs $450 (conflict); $375 annual renewal per DCP | — |
| Delaware | Yes | DHSS/DHCQ Personal Assistance Services Agency (PASA) license | $250 initial; $100 annual | — |
| Florida | Yes (registration) | AHCA Homemaker & Companion Services registration; HHA license for hands-on care | HCS registration $50.75 per 2 yrs (AHCA); statute base $50 per biennium. See the fee note below. | — |
| Georgia | Yes | DCH/HFRD Private Home Care Provider (PHCP) license | $300 application + $250 per service per year | Watch |
| Hawaii | Yes | DOH/OHCA Home Care Agency license (HAR 11-700) | $1,500 initial; renewal Not confirmed in official sources — check with the state agency | — |
| Idaho | No state license identified | Medicaid Personal Assistance Agency (PAA) provider enrollment | Not confirmed in official sources — check with the state agency | — |
| Illinois | Yes | IDPH Home Services Agency license | $1,500 (form); annual fee capped at $1,500 | — |
| Indiana | Yes | IDOH Personal Services Agency (PSA) license | $250 initial; $250 annual | Changed |
| Iowa | No state license identified | Iowa Medicaid HCBS provider enrollment (IAC 441-77) | Not confirmed in official sources — check with the state agency | — |
| Kansas | Yes | KDHE Home Health Agency license – non-medical supportive care | $250/$500 initial; $100/$350 renewal (by client count) | — |
| Kentucky | Yes (certification) | CHFS OIG Personal Services Agency certification | $500 initial; $350 annual | — |
| Louisiana | Yes (personal care) | LDH HCBS provider license, PCA module (FNR approval required) | $600 initial; $600 renewal (+module/branch fees) | — |
| Maine | Yes | DHHS DLC Personal Care Agency license | $500 initial; $200–$2,000 renewal by employee count | — |
| Maryland | Yes | MDH/OHCQ Residential Service Agency (RSA) license | $1,000 per 3-yr term (COMAR); application form says no fee to apply (sources conflict) | Watch |
| Massachusetts | Yes – new law, not yet implemented | EOHHS Home Care Agency license (Ch. 180, Acts of 2026) | Not yet set (Not confirmed in official sources — check with the state agency) | Changed |
| Michigan | No state license identified | MDHHS Home Help agency provider approval + CHAMPS enrollment (Medicaid) | Not confirmed in official sources — check with the state agency | — |
| Minnesota | Yes | MDH Home Care Provider license (Basic or Comprehensive) | $2,100 basic temporary license; annual fee by revenue | — |
| Mississippi | No state license | MS Division of Medicaid E&D Waiver provider enrollment | No enrollment fee identified (Not confirmed in official sources — check with the state agency) | Changed |
| Missouri | No (private pay) | No license; Medicaid in-home services via MMAC contract + enrollment | N/A (no license) | Watch |
| Montana | No state license identified | Medicaid provider enrollment (DPHHS programs) | Not confirmed in official sources — check with the state agency | — |
| Nebraska | No state license identified | Nebraska Medicaid provider enrollment (PAS/HCBS) | Not confirmed in official sources — check with the state agency | — |
| Nevada | Yes | License to operate an agency to provide personal care services in the home (NRS 449B) | Current Not confirmed in official sources — check with the state agency; proposed $1,374 / $687 | Watch |
| New Hampshire | Yes | DHHS Home Care Service Provider Agency license (He-P 822) | $25 (<10 clients) / $250 (10+); renewal Not confirmed in official sources — check with the state agency | — |
| New Jersey | Yes (registration) | DCA Health Care Service Firm registration + accreditation | Not confirmed in official sources — check with the state agency; $10,000 bond | Watch |
| New Mexico | No general license identified | Medicaid (Mi Via) certification or HHA license | HHA $300 (2025 rule); non-medical Not confirmed in official sources — check with the state agency | — |
| New York | Yes | DOH Licensed Home Care Services Agency (LHCSA), PHHPC approval | $2,000 application; renewal Not confirmed in official sources — check with the state agency | — |
| North Carolina | Yes | DHSR Home Care Agency license; Home Assistance Services Provider license (companion/sitter only) | $510 initial; $510 annual | — |
| North Dakota | No state license identified | HHS Qualified Service Provider (QSP) agency enrollment | Not confirmed in official sources — check with the state agency | — |
| Ohio | Yes | ODH Nonmedical Home Health Services license | $250 initial; $250 renewal (3-yr license) | Watch |
| Oklahoma | Yes | OSDH Home Care Agency license; Sitter/Companion agency license | Companion/sitter $1,000 initial, $500 renewal; home care agency initial Conflicting official figures — confirm current fee with the agency. (sources conflict), $500 renewal | — |
| Oregon | Yes | OHA In-Home Care Agency license (4 classes) | $2,000–$3,000 initial; $1,000–$1,500 annual | Changed |
| Pennsylvania | Yes | DOH Home Care Agency (HCA) / Home Care Registry (HCR) license | $100 initial; $100 annual | Changed |
| Rhode Island | Yes | RIDOH Home Care Provider license (+ Certificate of Need) | $650 annual licensure fee; CON fee $500 + 0.25% | — |
| South Carolina | Yes | DPH In-Home Care Provider license (Reg. 60-122) | $1,000 initial; $800 annual | Changed |
| South Dakota | No | No license (HB 1138 vetoed 2026); Medicaid via DHS LTSS | N/A (no license) | Watch |
| Tennessee | Yes | Personal Support Services Agency (PSSA) license – TDMHSAS or DDA | Not confirmed in official sources — check with the state agency | — |
| Texas | Yes | HHSC HCSSA license – Personal Assistance Services category | $2,625 initial; $2,625 per 3-yr renewal | Watch |
| Utah | Yes | DHHS Personal Care Agency license (R432-725) | FY2026-27 schedule: $743.83 base fee; $1,069.26 new-provider one-time fee (see entry) | — |
| Vermont | No state license identified | None found (home health designation applies to home health only) | Not confirmed in official sources — check with the state agency | — |
| Virginia | Yes (personal care) | VDH Home Care Organization license (companion-only exempt) | $1,500 per 3-yr term | — |
| Washington | Yes | DOH In-Home Services Agency license – home care category | $5,000 initial (12 mo); $2,400–$3,700 per 24-mo renewal | Changed |
| West Virginia | Registration | OHFLAC home care service provider registration (§15-2C-7) | No fee for registration | — |
| Wisconsin | No general license identified | DHS/DQA Personal Care Agency certification (Medicaid) | Fee required; amount Not confirmed in official sources — check with the state agency | — |
| Wyoming | No non-medical license confirmed | HHA license applies to health services; Medicaid HCBS certification | HHA $150; non-medical Not confirmed in official sources — check with the state agency | Watch |
Changes since March 2026
States are listed by significance. "CHANGED" items are in force or formally adopted; "WATCH" items are proposals, failed bills, or program-level changes.
| State | Status | What changed | Official source (as named in the guide) |
|---|---|---|---|
| Colorado | CHANGED | New 2026/27 fee schedule effective July 1, 2026 (amounts Not confirmed in official sources — check with the state agency). | Facility fees | Colorado Department of Public Health and Environment |
| Indiana | CHANGED | IDOH moved PSA licensing to its Gateway online process on May 1, 2026. | Personal Care Services Agency (PSA) Licensing Program |
| Massachusetts | CHANGED | Chapter 180 of 2026 (approved Aug 6, 2026) creates a home care agency license that will become mandatory on a date EOHHS has not yet set; regulations pending. As of October 15, 2026, no license was being issued. | Mass. Acts of 2026, Chapter 180 – An Act to Improve Massachusetts Home Care |
| Mississippi | CHANGED | MSDH Background Check Unit began final employment-eligibility determinations July 1, 2026; waiver letters discontinued. | MSDH Background Checks |
| Oregon | CHANGED | ODHS caregiver certification and public caregiver registry rules effective July 1, 2026. | [PDF] OAR 411-003 Permanent Rulemaking - Oregon.gov |
| Pennsylvania | CHANGED | Applications online only since Mar 31, 2026; mail/email no longer accepted. | Home Care | Department of Health - Commonwealth of Pennsylvania |
| South Carolina | CHANGED | Amendments to Regulation 60-122 took legal effect May 22, 2026. | SOUTH CAROLINA STATE REGISTER DISCLAIMER |
| Washington | CHANGED | New fee rule WAC 246-335-990 effective June 1, 2026. | WAC 246-335-990: - WA.gov |
| Georgia | WATCH | GCHEXS fingerprint policy added for Consumer Directed Care employers, effective July 1, 2026 (Medicaid program). | PART II - mmis.georgia.gov |
| Maryland | WATCH | OHCQ released draft COMAR 10.07.05 amendments (incl. training) for informal comment on Sept 9, 2026; not adopted. | health.maryland.gov |
| Missouri | WATCH | Family Care Safety Registry fee rose from $15 to $16 on Oct 1, 2026 (worker registry fee). | Family Care Safety Registry | Missouri Department of Health and ... |
| New Jersey | WATCH | P.L. 2026, c. 45 (July 22, 2026) changed Medicaid Personal Care Assistance thresholds and reporting. | PL 2026, CHAPTER 45, approved July 22, 2026 |
| Nevada | WATCH | Proposed fee regulation R071-26 (Apr 20, 2026) would set $1,374 initial / $687 renewal; adoption not confirmed. | Nevada LCB Draft Proposed Regulation R071-26 (Apr 20, 2026) |
| Ohio | WATCH | ODA rule 173-39-02.1 (Medicaid provider certification) effective Oct 1, 2026; substance Not confirmed in official sources — check with the state agency. | Chapter 173-39 - Ohio Administrative Code - Ohio Laws |
| South Dakota | WATCH | HB 1138 licensing bill vetoed; override failed Mar 30, 2026. Governor directed DOH to develop a new framework. | SD Legislature – 2026 HB 1138 bill history SD Governor news release, Mar 25, 2026 (veto of HB 1138) |
| Texas | WATCH | HHSC proposed HCSSA rule amendments published Sept 18, 2026 (Texas Register); not adopted. | Texas Register, Sept 18, 2026 – Proposed Rules, Title 26 |
| Wyoming | WATCH | Medicaid HCBS EVV minimum standard effective July 1, 2026. | Current Providers - Wyoming Department of Health |
Upcoming dates already set in law: California dementia-care annual training provision operative Jan 1, 2027 (SB 412, 2025); Connecticut 8 hours of paid employee training starting Jan 1, 2027 (P.A. 25-156). See those state entries for sources.
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