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Home health agency license requirements by state
Skilled nursing, therapy and aide visits in the home. Whether each state requires a license, who issues it, what it costs, certificate of need, electronic visit verification and the Medicaid rate, with the official source for each.
- States compiled
- 51 of 51
- Require a state license
- 46
- No state license
- 3
- States with a CON program
- 37of states compiled
On this page
By state
Home health agency requirements in every state
States still being compiled are marked; we only publish a state once its details are confirmed against the official source.
| State | License | Issuing agency | Fee | Renewal | CON program | EVV model | Medicaid rate |
|---|---|---|---|---|---|---|---|
| Alabama | Not required | Alabama State Health Planning and Development Agency (Certificate of Need); Alabama Department of Public Health, Bureau of Health Provider Standards (Medicare certification surveys) | — | — | Yes | open/provider choice | — |
| Alaska | Home Health Agency license | Alaska Department of Health, Health Facilities Licensing and Certification | Provisional license fee scales by FTEs: $1,000 (5 or fewe… | Every 2 years · Biennial renewal by FTEs: $2,000 (5 or fewer), $3,000 (6–15), $4,000 (16–50), $6,000 (51+), plus $1,000 per branch or subunit. Renewal information is due before April 1 of even-numbered years. | Yes | hybrid | — |
| Arizona | Health care institution license — home health agency | Arizona Department of Health Services, Bureau of Medical Facilities Licensing | $50 | — | No | hybrid | $24.73per 15 min |
| Arkansas | Home Health Agency license (Class A or Class B) | Arkansas Department of Health, Health Facility Services | — | Every year | Yes | hybrid | $66.63per visit |
| California | Home Health Agency (HHA) license | California Department of Public Health, Licensing and Certification Division — Centralized Applications Branch | An application fee applies under Health and Safety Code s… | — | No | hybrid | $15.21per 15 min |
| Colorado | Home Care Agency license — Class A | Colorado Department of Public Health and Environment, Health Facilities and Emergency Medical Services Division | $3,709.49 | Class A renewal base fee $1,916.58, plus $247.30 per branch and $61.83 per workstation; add $123.65 (50–99 annual admissions) or $247.30 (100+). Medicare/Medicaid-certified agencies deduct $100 and accredited (deemed) agencies take 10% off the base fee. Renewal is due 60 days before expiration; late fees run 10%–75% and the license is void at 90 days past expiration. | No | hybrid | $57.22per hour |
| Connecticut | Home Health Care Agency license | Connecticut Department of Public Health, Facility Licensing and Investigations Section (FLIS) | $300 | Non-certified agencies are licensed every two years ($300 per agency, $100 per satellite office); Medicare/Medicaid-certified agencies every three years ($300, plus $100 per satellite office). | Yes | hybrid | $54.12per visit |
| Delaware | Skilled Home Health Agency license | Delaware Department of Health and Social Services, Division of Health Care Quality | Fees are set under 16 Del.C. § 122(3)o; amounts are not p… | Every year | Yes | open/provider choice | $49.07per 15 min |
| District of Columbia | Home Care Agency license | DC Department of Health (DC Health), Health Regulation and Licensing Administration | Annual license fee by patient count: $400 (1–150 patients… | Every year · Same annual fee tiers; renewal application and fee are due 90 days before the license expires. | Yes | hybrid | $155.16per 15 min |
| Florida | Home Health Agency license | Florida Agency for Health Care Administration (AHCA), Laboratory and In-Home Services Unit | Fee is set by AHCA rule and may not exceed $2,000 per bie… | Every 2 years | Yes | hybrid | $32.07per visit |
| Georgia | Home Health Agency license/permit | Georgia Department of Community Health, Healthcare Facility Regulation Division (HFRD) | Licensure fee per DCH's Schedule of Licensure Activity Fe… | — | Yes | hybrid | $95.34per visit |
| Hawaii | Home Health Agency license | Hawaii Department of Health, Office of Health Care Assurance | — | Every 2 years · Renewal application due 30 days before expiration; the license is cancelled automatically if no renewal is filed. Fee not stated in the rule. | Yes | hybrid | $20.00per visit |
| Idaho | Home Health Agency (HHA) license | Idaho Department of Health and Welfare, Division of Licensing and Certification | — | Every year | No | open/provider choice | $38.40per visit |
| Illinois | Home Health Agency license | Illinois Department of Public Health, Office of Health Care Regulation | $1,500 | Every 2 years · $1,500 per two-year license. | Yes | hybrid | $111.00per VST |
| Indiana | License to Operate a Home Health Agency | Indiana Department of Health (IDOH), Home and Community Based Care Division | $250 | Every year · $250 annually (State Form 48851), filed 60–90 days before expiration; IDOH sends no reminders. | Yes | hybrid | $63.80per hour |
| Iowa | — | Iowa Department of Inspections, Appeals, and Licensing (DIAL), Health Facilities Division — Medicare Services Unit (certification surveys) | — | — | Yes | MCO-chosen | $98.87per visit |
| Kansas | Home Health Agency license | Kansas Department of Health and Environment (KDHE), Health Facilities Program | Annual fee is fixed by KDHE regulation (K.A.R. 28-51); th… | Every year · License stays in effect while an annual report and annual fee are filed; if not filed within 30 days of the renewal date the license is cancelled automatically. | No | hybrid | $20.00per 15 min |
| Kentucky | License to Operate a Home Health Agency | Kentucky Cabinet for Health and Family Services, Office of Inspector General, Division of Health Care | $500 | Every year · $500 annual licensure fee; late renewal penalty is the greater of 20% of the renewal fee or $25. | Yes | hybrid | — |
| Louisiana | Home Health Agency (HHA) license | Louisiana Department of Health (LDH), Health Standards Section | Licensing fee amount is set by LDH (not printed in the ru… | Every year · License renewal fee is due annually before expiration. A provisional license adds a fee equal to the annual fee for each follow-up survey. A change of ownership costs the full licensing fee. | Yes | hybrid | $24.73per 15 min |
| Maine | Home Health Care Services license | Maine Department of Health and Human Services, Division of Licensing and Certification | Each application must include the non-refundable fee set … | A full license runs up to 24 months; the department monitors compliance at least every two years. | Yes | hybrid | $16.48per 15 min |
| Maryland | Home Health Agency license | Maryland Department of Health, Office of Health Care Quality (OHCQ) | $0 | — | Yes | state-sponsored | $174.54 |
| Massachusetts | Home Health Agency license | Massachusetts Department of Public Health | Initial and renewal fees are set under M.G.L. c. 7 § 3B; … | Every 3 years | Yes | hybrid | $89.21per visit |
| Michigan | Not required | Michigan Department of Licensing and Regulatory Affairs (LARA) — no home health agency license; Medicare certification only for agencies billing Medicare | — | — | Yes | hybrid | $89.08per 15 min |
| Minnesota | Comprehensive Home Care License | Minnesota Department of Health, Health Regulation Division — Home Care | $4,200 | Every year · Annual renewal fee is based on prior-year home care revenue, from $231 (revenue up to $25,000) to $7,651 (over $1.5 million); a provider may instead pay the top fee and skip revenue reporting. | No | hybrid | $105.07per day |
| Mississippi | Home Health Agency license | Mississippi State Department of Health, Health Facilities Licensure and Certification | Initial and renewal applications carry a non-refundable f… | Every year · Licenses expire June 30 and renew annually with the fee, an approved annual report for the prior calendar year, and evidence of CON where applicable. | Yes | hybrid | $151.47per visit |
| Missouri | Home Health Agency license | Missouri Department of Health and Senior Services, Bureau of Home Care and Rehabilitative Standards | A non-refundable licensure fee must accompany the initial… | Every year · $600 non-refundable annual renewal fee, submitted before the license expires. | Yes | open/provider choice | $137.61per ea 15 mins |
| Montana | Home health agency license | Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau | An application fee must accompany the license application… | — | Yes | hybrid | — |
| Nebraska | Home health agency license | Nebraska Department of Health and Human Services, Division of Public Health, Licensure Unit (Office of Outpatient & In-Home Care Services) | $650 | Renewal fee is set in 175 NAC 14; DHHS mails a renewal notice and application before expiration. | Yes | hybrid | $100.21per visit |
| Nevada | License to operate a home health agency (home office or branch office); statute term 'agency to provide nursing in the home' | Health Care Purchasing and Compliance Division, Nevada Health Authority (NRS 449.0032; formerly DPBH) | $5,168 | Every year · Annual renewal: home office $2,584; branch office $2,679 (NAC 449.013). | Yes | hybrid | $28.46per 15 min |
| New Hampshire | Home health care provider (HHCP) license | New Hampshire Department of Health and Human Services, Office of Legal and Regulatory Services, Health Facilities Administration | $250 | Every year · Renewal application due at least 120 days before the license expires; the license runs to the last day of the month before the month of issue the following year. | No | hybrid | $129.00per day |
| New Jersey | Home health agency license | New Jersey Department of Health, Office of Certificate of Need and Healthcare Facility Licensure | $2,000 | Every year · $2,000 for each annual renewal, plus a $500 biennial inspection fee billed in the inspection year. | Yes | hybrid | $66.66per visit |
| New Mexico | Home health agency license (annual) | New Mexico Health Care Authority, Division of Health Improvement (Health Facility Licensing and Certification) | $300 | Every year · $300 annual renewal; renewal application due at least 30 days before expiration. A lapsed license means the agency must stop operating and reapply as new. | No | state-sponsored | $49.66per 15 min |
| New York | Certified home health agency (CHHA) approval under Public Health Law Article 36 | New York State Department of Health, with written approval of the Public Health and Health Planning Council (PHHPC) | $2,000 | — | Yes | open/provider choice | $179.96per visit |
| North Carolina | Home care agency license (multi-program) for a certified home health agency | NC DHHS Division of Health Service Regulation, Acute and Home Care Licensure and Certification Section (license); DHSR Certificate of Need Section (CON) | $510 | Every year · $510 per year; all home care licenses expire at midnight December 31. | Yes | hybrid | $41.36per day |
| North Dakota | Home health agency license | North Dakota Department of Health and Human Services (health facilities licensing) | No license fee appears in NDAC 33-03-10.1 or NDCC ch. 23-… | Every year · Licenses expire December 31 each year; renewal depends on compliance found in periodic unannounced surveys. | No | hybrid | $77.36per day |
| Ohio | Skilled home health services license | Ohio Department of Health | $250 | Every 3 years · License valid 3 years; a renewal is timely if filed at least 90 days before expiration with the renewal fee. ODH may align the date with Medicare certification or accreditation. | Yes | hybrid | $68.44per visit |
| Oklahoma | Home care agency license | Oklahoma State Department of Health, Medical Facilities Service, Home Services Division | $1,000 | Every year · $500 annual renewal ($25 per branch); renewals prorated to expire July 31 at $125 per quarter ($6.25 per branch). | Yes | hybrid | $21.45per 15 min |
| Oregon | Home health agency license | Oregon Health Authority, Public Health Division | $1,600 | Every year · $850 annual renewal plus $850 per subunit; licenses expire December 31 and renewal is due at least 30 days before. | Yes | hybrid | $17.19per day |
| Pennsylvania | Home health care agency license | Pennsylvania Department of Health, Division of Home Health | $250 | — | No | hybrid | $16.55per 15 min |
| Rhode Island | Home nursing care provider license | Rhode Island Department of Health | $650 | Every year · $650 annual; licenses expire December 31 and renew yearly subject to inspection. | Yes | hybrid | $18.36per 15 min |
| South Carolina | Home health agency license | South Carolina Department of Public Health | License fee $100 plus $50 per county served, due annually… | Every year · $100 + $50 per county served each year; routine inspection fee $250 biennial + $25 per county; follow-up inspection $125 + $25 per county. | Yes | state-sponsored | — |
| South Dakota | Not required | South Dakota Department of Health, Office of Health Facilities Licensure & Certification (Medicare certification surveys) | — | — | No | hybrid | $23.20per 15 min |
| Tennessee | Home care organization license — home health services | Tennessee Health Facilities Commission | $1,404 | Every year · Licenses expire each year on the anniversary of issuance. Late renewal within 60 days costs an extra $100 per month; after 60 days the agency must reapply. | Yes | MCO-chosen | — |
| Texas | Home and Community Support Services Agency (HCSSA) license — licensed and certified home health services (L&CHHS) category | Texas Health and Human Services Commission | $2,625 | $2,625 for a 3-year renewal or $1,750 for a 2-year renewal (same for branches); late fee is half the renewal fee. | No | hybrid | $98.92per 15 min |
| Utah | Home health agency license | Utah Department of Health and Human Services, Division of Licensing and Background Checks | — | — | No | open/provider choice | $151.30per day |
| Vermont | Home health agency designation for a geographic service area | Vermont Department of Disabilities, Aging and Independent Living (designation); Green Mountain Care Board (CON) | — | Every 4 years · Designation lasts 4 years; agencies apply for redesignation in a form set by the Commissioner. | Yes | hybrid | $68.00per day |
| Virginia | Home care organization license | Virginia Department of Health, Office of Licensure and Certification | $1,500 | Every 3 years · $1,500 per triennial renewal; $50 late fee. | Yes | open/provider choice | $45.12per day |
| Washington | In-home services agency license — home health service category | Washington State Department of Health | $5,000 | Every 2 years · 24-month renewal fee by FTEs for home health: $5,100 (5 or fewer) to $10,600 (101+); $3,600 to $7,400 if Medicare-certified or accredited. Late fee $50/day up to $1,000. CHOW $500 per category. | Yes | open/provider choice | $95.55per DL |
| West Virginia | — | West Virginia Health Care Authority (Certificate of Need) | — | — | Yes | hybrid | $125.34 |
| Wisconsin | Home health agency license | Wisconsin Department of Health Services, Division of Quality Assurance | $300 | No license renewal: a regular license is valid indefinitely. An annual continuing fee equals 0.25% of patient fee revenue (minimum $500, maximum $2,500). | Yes | hybrid | $42.33per visit |
| Wyoming | Home health agency license | Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys (HLS) | Initial license fee not confirmed: a 1998 fee rule (Chapt… | Every year · $150 annual renewal (2026 HLS renewal application). New facilities and ownership changes use a different form. | No | hybrid | — |
Medicaid rate: the home health nurse visit (rn or lpn) fee-for-service rate, linked to the state's fee schedule. Fees as printed by the licensing agency; where it gives a range or formula, the page for that state has the wording.