Start a business · Hospice
Hospice license requirements by state
End-of-life care at home or in a facility. Whether each state requires a license, who issues it, what it costs, certificate of need and the Medicaid rate, with the official source for each.
- States compiled
- 51 of 51
- Require a state license
- 44
- No state license
- 4
- States with a CON program
- 37of states compiled
On this page
By state
Hospice 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 | Medicaid rate |
|---|---|---|---|---|---|---|
| Alabama | Hospice license (regular or probational) | Alabama Department of Public Health (State Board of Health), Bureau of Health Provider Standards | Application must include the statutory fee under Code of … | Every year · Licenses run for the calendar year and expire December 31 unless renewed; renewal requires application and fee as for the original license. | Yes | $172.10 |
| Alaska | Hospice agency license (volunteer, full-service/non-volunteer, or inpatient hospice facility); provisional, then biennial | Alaska Department of Health, Health Facilities Licensing & Certification | Provisional license: volunteer in-home hospice $100; non-… | Every 2 years · Biennial renewal fees: volunteer $200, non-volunteer $500, inpatient facility $500 + $150/bed, +$200 per subunit. Renewal application is due 90 days before the license expires. | Yes | — |
| Arizona | Health care institution license — hospice service agency or hospice inpatient facility | Arizona Department of Health Services, Bureau of Medical Facilities Licensing | $50 application fee when the application is filed. Licens… | — | No | $190.02per day |
| Arkansas | Hospice license (in-home hospice; in-patient direct care hospice) | Arkansas Department of Health, Health Facility Services (Health Systems Licensing and Regulation) | The rule requires a licensure fee (e.g., on change of own… | Every year | Yes | $80.36per day |
| California | Hospice agency license (Health and Safety Code ch. 8.5); separate hospice facility license for inpatient hospice facilities | California Department of Public Health, Center for Health Care Quality, Centralized Applications Branch (CAB) | — | — | No | $260.10 |
| Colorado | Hospice license (provisional, then regular; inpatient hospice facility rules included) | Colorado Department of Public Health and Environment, Health Facilities and Emergency Medical Services Division | Fees (initial, renewal, provisional, conditional, change … | Every year · Renewal application and fee due at least 60 days before license expiration; late fees apply. | No | $210.41 |
| Connecticut | Hospice agency license (also: hospice inpatient facility; short-term hospital special hospice) | Connecticut Department of Public Health, Facility Licensing and Investigations Section | Per CGS 19a-491: hospice agency satellite patient service… | Every 2 years · Licensing and inspection is biennial for most institutions; for Medicare/Medicaid-certified hospice agencies described in CGS 19a-493, satellite-office fees are charged on a triennial cycle. | Yes | $203.25 |
| Delaware | Hospice license (annual; provisional license up to 3 months possible) | Delaware Department of Health and Social Services, Division of Health Care Quality | $100 | Every year · $50 annual licensure fee; renewal applications must be filed at least 30 days before expiration. | Yes | — |
| District of Columbia | Hospice license (Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act) | DC Health, Health Regulation and Licensing Administration (HRLA), Office of Health Facilities | — | — | Yes | $95.00per % |
| Florida | Hospice license (may include freestanding inpatient facility and residential units) | Florida Agency for Health Care Administration (AHCA), Bureau of Health Facility Regulation, Home Care Unit | License fee is set by rule and capped by statute at $1,20… | Every 2 years | Yes | $182.79per day |
| Georgia | Hospice license (initial 6-month license, then regular license; inpatient/residential services covered under the same license) | Georgia Department of Community Health, Healthcare Facility Regulation Division | — | — | Yes | $186.66per day |
| Hawaii | Not required | Hawaii Department of Health, Office of Health Care Assurance (OHCA) — federal certification survey agency | — | — | Yes | $479.34per day |
| Idaho | Not required | — | — | — | No | $181.75per day |
| Illinois | Hospice program license — comprehensive or volunteer hospice program | Illinois Department of Public Health | $500 | Every year · $500 annual renewal; file 60 days before the license expires. | Yes | — |
| Indiana | License/approval to operate a hospice program (IC 16-25-3) | Indiana Department of Health, Hospice Agency Licensure and Certification Program | $100 | Renewal uses the Re-Application/Approval for License Approval to Operate a Hospice form; fee per that form. | Yes | $294.00per day |
| Iowa | Not required | Iowa Department of Inspections, Appeals, and Licensing, Division of Health Facilities | $500 | Every 2 years · $500 per two-year license; +25% if the license lapses. | Yes | $187.01per day |
| Kansas | Not required | Kansas Department of Health and Environment (enforcement of K.S.A. 65-6202 via injunction) | — | — | No | $202.68per day |
| Kentucky | Hospice license (freestanding hospice, or hospice operated by a hospital, long-term care facility, home health agency, HMO or other licensed facility) | Kentucky Cabinet for Health and Family Services, Office of Inspector General | — | — | Yes | — |
| Louisiana | Hospice license (home-based hospice, with optional inpatient hospice facility and branches) | Louisiana Department of Health, Health Standards Section (HSS) | Fees are set by LDH; listed on the HSS page: branch $300 … | — | Yes | $202.89 |
| Maine | Hospice provider license (provisional, then full or conditional) | Maine Department of Health and Human Services, Division of Licensing and Certification | $200 | The rule says licenses are renewed every two years on payment of the fee, while also assessing a $200 annual fee; the Department sends a renewal application at least 50 days before expiration and it is due 20 days before expiration. | Yes | $223.84per day |
| Maryland | General hospice care program license (license with conditions until federal certification, then license without conditions) | Maryland Department of Health, Office of Health Care Quality (OHCQ) | $0 | — | Yes | — |
| Massachusetts | Hospice program license (home-based; inpatient hospice program licenses capped) | Massachusetts Department of Public Health | Fee is set by DPH (statute delegates fee to the departmen… | Every 2 years · Licenses are issued and renewed for 2-year terms; DPH sets the renewal fee. | Yes | $231.13per day |
| Michigan | Hospice agency license; hospice residence license | Michigan Department of Licensing and Regulatory Affairs (LARA), Bureau of Community and Health Systems | Per MCL 333.20161 (in effect until 2027-10-01): annual li… | Every year · Fees are assessed annually: $500 per hospice agency license; $500 + $5/bed per hospice residence. | Yes | $180.60per day |
| Minnesota | Hospice provider license | Minnesota Department of Health, Health Regulation Division | Initial and renewal fee scales with hospice revenue: $150… | — | No | — |
| Mississippi | Hospice license (per site/location) | Mississippi State Department of Health, Bureau of Health Facilities Licensure and Certification | $1,000 | Every year · Licenses expire automatically on June 30 each year; the renewal packet must be returned with the current annual licensure fee. | Yes | $166.09 |
| Missouri | Missouri hospice state certification (temporary operating permit, then annual certificate) | Missouri Department of Health and Senior Services, Home Care and Rehabilitative Standards | $500 | Every year · Annual renewal fee by admissions: 0-50 $250; 51-150 $400; 151-250 $550; 251+ $750. Renewal application due before the prior certificate expires. | Yes | $178.98per day |
| Montana | Hospice license — hospice program (in-home), in-patient hospice, or residential hospice | Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau | A license fee must accompany the application; amount not … | — | Yes | — |
| Nebraska | Hospice service license (non-inpatient or inpatient hospice) | Nebraska Department of Health and Human Services, Division of Public Health, Licensure Unit | Initial licensure fee: $450 for other than inpatient; $65… | — | Yes | $305.10 |
| Nevada | License to operate a program of hospice care (separate license for a facility for hospice care) | Nevada Department of Health and Human Services, Division of Public and Behavioral Health (DPBH), Bureau of Health Care Quality and Compliance | $7,054 | Renewal: program of hospice care $3,527 (+6% surcharge); facility for hospice care $1,994 + $176 per bed. License modifications have separate fees (NAC 449.0168). | Yes | — |
| New Hampshire | Home hospice care provider (HHCP) license | New Hampshire Department of Health and Human Services, Health Facilities Administration | $250 | Every year · Licenses expire about one year after issuance (last day of the month before the issue month); renewal application due at least 120 days before expiration. | No | $192.30 |
| New Jersey | Hospice care program license (with optional inpatient hospice care unit) | New Jersey Department of Health, Office of Certificate of Need and Healthcare Facility Licensure | In addition to the licensure/renewal fee, inspection fees… | — | Yes | $219.21per day |
| New Mexico | Hospice license — in-home hospice agency or inpatient hospice facility (annual; temporary license up to 120 days) | New Mexico Health Care Authority (licensing authority for health facilities) | License fees are payable as set out in the licensing auth… | Every year | No | $184.60 |
| New York | Certificate of approval to operate a hospice (Public Health Law Article 40) | New York State Department of Health, with establishment approval by the Public Health and Health Planning Council (PHHPC) | — | — | Yes | $317.60per day |
| North Carolina | Hospice agency license (each site separately licensed; may be part of a multi-program home care license) | North Carolina DHHS, Division of Health Service Regulation, Acute and Home Care Licensure and Certification Section | The appropriate licensure fee must accompany the applicat… | — | Yes | $186.00 |
| North Dakota | Hospice program license (also residential hospice facility) | North Dakota Department of Health and Human Services, Health Facilities Unit | A uniform license fee set by the department; amount not s… | Every year | No | — |
| Ohio | Hospice care program license (3-year) | Ohio Department of Health | License and renewal fees are set by Director of Health ru… | Every 3 years · Renewal fee capped at $600 per 3-year term (subject to ORC 3712.03(B)); apply at least 90 days before expiration. In-home programs must show compliance with ORC 3712.062 at renewal. | Yes | — |
| Oklahoma | Hospice license — first-year license, then permanent (annual) license | Oklahoma State Department of Health, Medical Facilities Service | $2,000 | Every year · $2,000 annual renewal of a permanent license; $50 late fee if filed within 30 days after expiration. | Yes | $186.57 |
| Oregon | Hospice program license | Oregon Health Authority, Public Health Division, Health Care Regulation and Quality Improvement | $1,140 | $1,140 renewal fee. | Yes | $215.11per day |
| Pennsylvania | Hospice agency license (Health Care Facilities Act, Chapter 8) | Pennsylvania Department of Health, Division of Home Health | $250 | — | No | — |
| Rhode Island | Hospice program license (annual; hospice inpatient facility license where applicable) | Rhode Island Department of Health (RIDOH), Facilities Regulation / Licensing | Application and renewal fees are set in RIDOH's fee-struc… | Every year · Licenses expire December 31 following issuance and renew yearly subject to inspection; renewal fee per the fee-structure rule. | Yes | $222.38per day |
| South Carolina | Hospice program (outpatient) license; hospice facility (inpatient) license | South Carolina Department of Public Health (DPH), Healthcare Quality — Healthcare Facility Licensing | Initial and renewal license fee $100 plus $50 per county … | Same as initial ($100 + $50/county; facility bed fee). Late renewal: 25% of the license fee, minimum $75. | Yes | $173.92per day |
| South Dakota | — | South Dakota Department of Health, Office of Health Care Facilities Licensure & Certification | — | — | No | $186.33per day |
| Tennessee | Home care organization license providing hospice services | Tennessee Health Facilities Commission (licensure and Certificate of Need) | $1,404 | — | Yes | $100.00per percent of federal Medicaid hospice rate |
| Texas | HCSSA license with hospice services category (parent, branch, alternate delivery site, inpatient unit) | Texas Health and Human Services Commission (HHSC), Long-Term Care Regulation — HCSSA Licensing | $2,625 | Every 3 years · HHSC is phasing in a three-year term. Renewal: two-year license $1,750 (ADS $600); three-year license $2,625 (ADS $900). Late fee if filed less than 45 days before expiration: $875 / $1,312.50 (ADS $300 / $450). Renewals filed after expiration are not accepted. | No | $182.18per day |
| Utah | Health care facility license — hospice (hospice agency; hospice inpatient facility) | Utah Department of Health and Human Services, Division of Licensing and Background Checks (Office of Licensing) | — | — | No | $183.64per day |
| Vermont | — | Vermont Department of Disabilities, Aging and Independent Living, Division of Licensing and Protection | — | — | Yes | — |
| Virginia | Hospice program license (and hospice facility license) | Virginia Department of Health, Office of Licensure and Certification (OLC) | $500 | $500 renewal; $50 late fee for a late renewal application. | Yes | $190.23per Daily Rate |
| Washington | In-home services agency license with hospice service category (separate hospice care center license for facilities) | Washington State Department of Health | $5,000 | Every 2 years · 24-month renewal fee scales with paid FTEs (minimum 2 FTE assumed). Medicare-certified or recognized-accredited hospices (Table 2): $1,800 (<=5 FTE), $2,000 (6-15), $2,600 (16-50), $4,500 (51-100), $4,700 (101+). Standard (Table 1) rates are higher, e.g., $6,700 for 101+ FTE. | Yes | $220.08per Capitated Daily Rate; Days 61+ Rate |
| West Virginia | — | West Virginia Department of Health, Office of Health Facility Licensure and Certification (OHFLAC); Certificate of Need through the West Virginia Health Care Authority | — | — | Yes | $187.58 |
| Wisconsin | Hospice license (provisional, then permanent) | Wisconsin Department of Health Services, Division of Quality Assurance (DQA), Bureau of Health Services | $300 | Every year · Permanent license: yearly fee of 0.15% of the agency's net annual income, ranging from $200 to $1,000. | Yes | $192.39per day |
| Wyoming | Hospice program license (health care facility license) | Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys | Licensure fee per HLS Chapter 1 (Licensure Fees). The 201… | Every year · Licenses run from issuance through the following June 30 and are renewed annually. | No | $180.08per day |
Medicaid rate: the hospice routine home care (daily) 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.