How to Start A Home Health Agency in Montana (2026): License, Medicaid Enrollment & Rates

Licensing

Montana home health agency license

Montana requires a Home health agency license from Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau to operate a home health agency. Fee: An application fee must accompany the license application; the amount is not printed on the bureau's HHA page or applicant letter. Processing time: After documents are approved the bureau issues a 6-month provisional license; the on-site survey happens during that provisional period. Do not apply more than 6 months before the target licensure date; stalled applications are withdrawn under bureau policy.

License required: Yes
License: Home health agency license
Issuing agency: Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau
Fee: An application fee must accompany the license application; the amount is not printed on the bureau's HHA page or applicant letter.
Processing time: After documents are approved the bureau issues a 6-month provisional license; the on-site survey happens during that provisional period. Do not apply more than 6 months before the target licensure date; stalled applications are withdrawn under bureau policy.
Survey and inspection: A Licensure Bureau surveyor conducts an on-site survey during the provisional license period. Under ARM 37.106.310 a license may then be issued for 1, 2 or 3 years depending on survey results, accreditation and time in operation.
Certificate of need: Not required
Medicare certification: Licensing and Medicare certification are separate; certification is handled by the DPHHS Certification Bureau. Separately, CMS put a 6-month nationwide moratorium on new Medicare enrollment of home health agencies (including new branches and practice locations) into effect on May 13, 2026; it can be extended in 6-month increments, and CMS left any Medicaid/CHIP moratorium to each state.
Regulation: ARM Title 37, ch. 106 (incl. ARM 37.106.310 license issuance/renewal); Title 50, ch. 5, MCA

How to apply

Steps to get licensed in Montana

In order, as the licensing agency describes the process.

Submit the license application and fee through the bureau's online portal
Send the BFS plan submittal form to the bureau's construction consultant
Submit policies and procedures for approval at least 45 days before the planned opening
Provide the list of counties to be served and a list of professional staff with license numbers
Provide the prospective administrator's attestation that they have reviewed the HHA rules
Receive a 6-month provisional license (no patients may be accepted before licensure)
Pass the on-site licensure survey during the provisional period

Documents

What you need to submit

6 documents listed by the licensing agency.

Document
License application and fee
BFS plan submittal form
Policies and procedures

See the full checklist — start free

Every document for every state, with sources, side by side and exportable.

Full checklist
Every state
CSV export

Start free trial Sign in

Medicaid

Enrolling as a Montana Medicaid provider

Program: Montana Healthcare Programs (Montana Medicaid, HELP/Medicaid expansion, Healthy Montana Kids Plus)
Enrollment portal: MPATH Provider Services Portal
Fiscal agent: Conduent (Montana Provider Relations handles enrollment and claims); DPHHS says claims move to Gainwell Technologies' new Montana Healthcare Claims System in 2027
Application fee: Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. Montana's own pages do not list a separate state enrollment fee.
Fingerprinting: Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. Montana's screening and enrollment disclosure form restates these federal rules; it does not list which provider types are high risk.
Site visit: Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. Montana's screening and enrollment disclosure form restates these federal rules.
Revalidation: Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. Montana's enrollment page says sole-proprietor revalidations filed under a tax ID shared with another provider are denied.

Full Montana Medicaid enrollment guide →

Certificate of need

Does Montana require a certificate of need?

For this business: Not required (licensing source)
CON program: Yes
Program: Certificate of Need (long-term care)
Agency: Montana Department of Public Health and Human Services
Services covered: long-term care facilities (skilled nursing, intermediate nursing and intermediate developmental disability care to 2+ individuals): new or replacement facilities, bed increases or relocations above 10 beds / 10%, acquisitions of 50%+ ownership
new long-term care health services adding $150,000+ in annual operating and amortization expense
hospital use of more than five beds for nursing-level care and hospital long-term care services

Montana certificate of need details →

EVV

Electronic visit verification in Montana

Model: hybrid
State vendor: Netsmart (Mobile Caregiver+)
Services in scope: personal care
home health
other applicable HCBS
Alternate EVV allowed: Yes
Program: https://dphhs.mt.gov/SLTC/EVV

Montana EVV requirements →

Labor

Montana wage floor

State minimum wage: $10.85 an hour
Effective: 2026-01-01
Scheduled increases: Adjusted each January 1 for inflation (calculated by September 30); the 2027 rate was not found in the sources reviewed.
HCBS 80/20 rule: Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Market

Montana market size

Counts from federal public files: NPPES (active organization NPIs), CMS Care Compare and CMS Medicaid enrollment.

Home health agencies — active organization NPIs (NPPES): 127 (as of Sep 13, 2026)
Medicare-certified home health agencies (CMS Care Compare): 21 (as of May 27, 2026)
Total Medicaid and CHIP enrollment (latest reported month): 205,414 (as of Jun 1, 2026)

Rates

What Montana Medicaid pays

Home health: published Montana fee-for-service rates, each linked to its source.

Montana Medicaid rates for this service: being compiledWe publish a state's details only once they are confirmed against the official source, with links to it. This state's record is still being researched.

Montana Medicaid fee schedule

FAQ

Frequently asked questions

Do you need a license to start a home health agency in Montana?

Montana requires a Home health agency license from Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau to operate a home health agency. Fee: An application fee must accompany the license application; the amount is not printed on the bureau's HHA page or applicant letter. Processing time: After documents are approved the bureau issues a 6-month provisional license; the on-site survey happens during that provisional period. Do not apply more than 6 months before the target licensure date; stalled applications are withdrawn under bureau policy.

How much does a home health agency license cost in Montana?

An application fee must accompany the license application; the amount is not printed on the bureau's HHA page or applicant letter.

How long does it take to get licensed in Montana?

After documents are approved the bureau issues a 6-month provisional license; the on-site survey happens during that provisional period. Do not apply more than 6 months before the target licensure date; stalled applications are withdrawn under bureau policy.

Does Montana require a certificate of need for a home health agency?

No, according to the licensing source. Montana's CON program covers: long-term care facilities (skilled nursing, intermediate nursing and intermediate developmental disability care to 2+ individuals): new or replacement facilities, bed increases or relocations above 10 beds / 10%, acquisitions of 50%+ ownership, new long-term care health services adding $150,000+ in annual operating and amortization expense, hospital use of more than five beds for nursing-level care and hospital long-term care services.

How do you become a Medicaid provider in Montana?

Enroll through MPATH Provider Services Portal (https://portal.mt.healthinteractive.net/icapPortal/), run by Conduent (Montana Provider Relations handles enrollment and claims); DPHHS says claims move to Gainwell Technologies' new Montana Healthcare Claims System in 2027.

How to start a home health agency in Montana