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Non-medical home care agency licensing by state

Personal care and companion services in clients' homes, without skilled nursing

A non-medical home care agency sends aides into clients’ homes for personal care, homemaking or companionship, with no skilled nursing. Of the 50 states and DC, 30 license it, Connecticut, Florida and New Jersey only register it, and the rest either certify it for Medicaid or have no state rule at all. Two questions decide where you stand: does your state license this work, and do you give hands-on care?

Size rarely matters, staff does

Most licensing states set no client minimum. Delaware, Maine, South Carolina and Tennessee require the license of any agency, however small. The usual exemption is the person working alone: Georgia and Colorado exempt a worker with no employees, Hawaii exempts individuals even if incorporated, and Washington exempts anyone hiring fewer than two people. Indiana and Kentucky also exempt very small caseloads, such as Kentucky’s individuals serving no more than three clients at a time.

Hands-on care versus companionship

The line between personal care (bathing, dressing, toileting) and companionship decides which rule applies. Texas licenses only hands-on personal care and leaves companion and sitter services unlicensed; Maryland exempts agencies giving only household or family support. Florida registers homemaker and companion agencies with AHCA but bars hands-on care, and Minnesota has housekeeping-only providers register instead of holding the Basic Home Care License. Oklahoma and North Carolina go the other way and license companion-only agencies separately; Oklahoma’s Companion/Sitter license had a $1,000 initial fee as of 2026-10-12. Rhode Island has no unlicensed companion tier at all.

States without a license

Alabama, Arizona, Iowa, Michigan, Missouri, Montana, New Mexico, South Dakota and Wyoming have no state license for private-pay agencies. Alaska, Idaho, Mississippi, North Dakota, Vermont and Wisconsin regulate only agencies paid by Medicaid, through certification, provider agreements or enrollment. In several of these states, including Arizona and Iowa, that conclusion rests on the absence of any rule rather than an official statement. Nebraska requires a home health agency license once you add home health aide or skilled services, and Wyoming does once an agency provides two or more health care services, home health aide care included.

Many names, several structures

California and Virginia license a Home Care Organization, Indiana a Personal Services Agency, Maryland a Residential Service Agency, Georgia a Private Home Care Provider, DC a Home Support Agency, and Ohio a Nonmedical Home Health Services agency. Kansas issues a home health agency license for non-medical supportive care, and New York has no separate non-medical tier: you need a full Licensed Home Care Services Agency license. Colorado makes it Class B of one Home Care Agency license, and Oregon splits its In-Home Care Agency license into four classes.

Some states count licenses by office or business model. Pennsylvania licenses agencies and registries separately and requires a license for each office; DC licenses each operating office. Illinois has a separate placement agency license, and Louisiana adds services as modules on one HCBS license.

Need reviews and moratoriums

New York requires proof of public need: since April 1, 2020, five or more agencies in a county each serving 25 or more patients creates a presumption of no need. Louisiana requires Facility Need Review approval before the personal care module. Rhode Island required a certificate of need before the Home Care Provider license until June 12, 2026, when its FY2027 budget (P.L. 2026, ch. 84) removed home-care providers from the certificate of need law. West Virginia requires a certificate of need for Medicaid personal care. Past freezes ended in North Carolina in 2019 and in New York in 2020.

Recent changes

Massachusetts enacted a home care agency license in August 2026, but it is not required until EOHHS issues regulations and sets a compliance date. South Carolina’s revised In-Home Care Provider rule took effect May 22, 2026, and Nevada moved its statute to NRS chapter 449B in 2025.

Across the 50 states and DC

What each state requires to operate, at our last review

30 of 51
License required
3 of 51
Registration required
6 of 51
Medicaid/Medicare certification only
12 of 51
No state license
Guides
33 below

Non-medical home care agency rules in every state

All states
Non-medical home care agency licensing in each state: requirement, official license name, agency and size threshold
Alabama No state license None found (no state license for non-medical home care) No licensing agency identified No state license found for private-pay companion or homemaker agencies
Alaska Medicaid/Medicare certification only Personal care services agency certification (Medicaid) Alaska Department of Health, Division of Senior and Disabilities Services No state license; certification only to bill Medicaid
Arizona No state license None; no ADHS license class No state licensing agency No state license for private-pay companion or personal care agencies
Arkansas License required Private Care Agency license Arkansas Department of Health, Health Facility Services In-home personal and attendant care staffing; license is for Medicaid care
California License required Home Care Organization (HCO) license California Department of Social Services (CDSS), Community Care Licensing Division, Home Care Services Branch Any agency sending aides for personal care or companionship
Colorado License required Home Care Agency license, Class B Colorado Department of Public Health and Environment (CDPHE), Health Facilities and Emergency Medical Services Division Agency providing personal care only; no skilled services
Connecticut Registration required Homemaker-Companion Agency registration Department of Consumer Protection (DCP), License Services Division Any agency with 1+ employee giving companion or homemaker services
Delaware License required Personal Assistance Services Agency license Delaware Department of Health and Social Services (DHSS), Division of Health Care Quality (DHCQ) Any agency referring care workers to help people at home; no threshold
District of Columbia License required Home Support Agency license DC Department of Health (DC Health), Health Care Facilities Division Agency employing aides for personal care; licensed per DC office
Florida Registration required Homemaker and Companion Services registration Agency for Health Care Administration (AHCA) Companion and homemaker services only; no hands-on care
Georgia License required Private Home Care Provider license Department of Community Health, Healthcare Facility Regulation Division (HFRD) Companion, personal care or nursing in homes; solo workers exempt
Hawaii License required Home Care Agency license Department of Health (DOH), Office of Health Care Assurance (OHCA) Any agency giving personal care, homemaker or respite help in clients' homes
Idaho Medicaid/Medicare certification only Personal Assistance Agency (Medicaid provider agreement) Idaho Department of Health and Welfare, Division of Medicaid, Bureau of Long Term Care No state license; Medicaid provider agreement only
Illinois License required Home Services Agency license (Home Services Placement Agency license if you only place workers) Illinois Department of Public Health (IDPH), Office of Health Care Regulation Employing or placing home services workers in clients' homes
Indiana License required Personal Services Agency (PSA) license Indiana Department of Health (IDOH), Division of Home and Community-Based Care Paid attendant, homemaker or companion care; exempt: 3 per home, 7 total
Iowa No state license None; no state license for private-pay home care agencies No state licensing agency No state license for private-pay companion or personal care agencies
Kansas License required Home Health Agency license, Non-Medical Supportive Care Services Kansas Department of Health and Environment (KDHE), Bureau of Facilities and Licensing Any agency paid to give non-nursing help with daily living at home
Kentucky License required Personal Services Agency Certification (certificate) Cabinet for Health and Family Services (CHFS), Office of Inspector General Paid personal care, companion or respite agency; exempt: 3 clients at a time
Louisiana License required Home and Community-Based Services (HCBS) Provider License, Personal Care Attendant module Louisiana Department of Health (LDH), Health Standards Section In-home personal care needs an HCBS license; sitter-only does not
Maine License required Personal Care Agency (PCA) License Maine DHHS, Division of Licensing and Certification (DLC) Any agency employing staff for in-home daily living help; no minimum
Maryland License required Residential Service Agency (RSA) License Maryland Department of Health (MDH), Office of Health Care Quality (OHCQ) Home health aide or personal care in homes; household help only is exempt
Massachusetts No state license Home care agency license (enacted August 2026, not yet required) Executive Office of Health and Human Services (EOHHS) No license yet; Acts 2026 c.180 will require one for any in-home care business
Michigan No state license None (no state license for non-medical home care) None No state license for non-medical home care agencies
Minnesota License required Basic Home Care License Minnesota Department of Health (MDH), Health Regulation Division Paid in-home help with daily tasks; no size threshold
Mississippi Medicaid/Medicare certification only Personal Care Services provider, Elderly & Disabled Waiver Mississippi Division of Medicaid, Office of Long-Term Care No state license; Medicaid waiver enrollment only
Missouri No state license No state license (private-pay home care); Medicaid In-Home Services provider contract for state-paid care No licensing agency No state license for private-pay home care; Medicaid needs a contract
Montana No state license No state license for private-pay non-medical home care None for private-pay care No state license; only Medicaid personal care providers enroll
Nebraska No state license No separate license (companion and homemaker care) Nebraska DHHS, Licensure Unit No separate license; any aide or skilled service needs a home health license
Nevada License required Agency to Provide Personal Care Services in the Home (personal care agency) license Nevada Health Authority, Health Care Purchasing and Compliance Division (HCQC) Any business (not a solo contractor) giving in-home personal care
New Hampshire License required Home Care Service Provider Agency (HCSPA) license, personal care services or homemaker services classification Department of Health and Human Services (DHHS), Health Facilities Administration, Health Facilities Licensing Unit Agency with staff giving only personal care or homemaker services
New Jersey Registration required Health Care Service Firm registration Division of Consumer Affairs, Department of Law and Public Safety Agencies placing companion, personal or health care workers in homes
New Mexico No state license No state license for non-medical home care New Mexico Health Care Authority (HCA), Division of Health Improvement No state license for non-medical home care
New York License required Licensed Home Care Services Agency (LHCSA) license Department of Health (DOH), with approval by the Public Health and Health Planning Council (PHHPC) One home care license for all agencies; public need required
North Carolina License required Home Care Agency license (hands-on in-home aide services) or Home Assistance Services Provider license (companion, sitter, respite, homemaker only) NC DHHS, DHSR Acute and Home Care Licensure and Certification Section License required; hands-on care needs a home care agency license
North Dakota Medicaid/Medicare certification only Qualified Service Provider (QSP) enrollment, agency or individual North Dakota HHS, Adults and Aging Services (Qualified Service Provider program) No state license; QSP enrollment needed for state-funded clients
Ohio License required Nonmedical Home Health Services license Ohio Department of Health (ODH) Hands-on personal care or home health aide services in clients' homes
Oklahoma License required Companion/Sitter Service Agency license; Home Care Agency license Oklahoma State Department of Health (OSDH), Medical Facilities Service, Home Services Division Any agency offering companion or sitter services must be licensed
Oregon License required In-Home Care Agency license Oregon Health Authority (OHA), Public Health Division, Health Care Regulation and Quality Improvement - Health Facility Licensing and Certification, In-Home Care Program Any agency providing paid personal care in clients' homes
Pennsylvania License required Home Care Agency license or Home Care Registry license Department of Health, Division of Home Health Agencies and registries for personal care or companionship
Rhode Island License required Home Care Provider license Rhode Island Department of Health (RIDOH), Center for Health Facilities Regulation Any in-home care or homemaker agency; no certificate of need since June 12, 2026
South Carolina License required In-Home Care Provider license South Carolina Department of Public Health (DPH), Healthcare Quality Any business providing or arranging in-home help with daily living tasks
South Dakota No state license None No state agency No state license for bathing, housekeeping or meal help at home
Tennessee License required Personal Support Services Agency (PSSA) license Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS), or Department of Disability and Aging (DDA) if most clients have intellectual or developmental disabilities Licensed at any size; no minimum client count
Texas License required Home and Community Support Services Agency (HCSSA) license, Personal Assistance Services category Texas Health and Human Services Commission (HHSC), Long-term Care Regulation Hands-on personal care in homes; companion-only is exempt
Utah License required Personal Care Agency License Utah Department of Health and Human Services (DHHS), Division of Licensing and Background Checks, Office of Licensing Two or more people giving personal care in homes; no medical tasks
Vermont Medicaid/Medicare certification only Home Care Provider certification (Choices for Care) Vermont DAIL, Adult Services Division No license; DAIL certification only to bill Medicaid (Choices for Care)
Virginia License required Home Care Organization (HCO) license, personal care services Virginia Department of Health (VDH), Office of Licensure and Certification Any organization giving personal care in clients' homes; no minimum size
Washington License required In-Home Services Agency License (home care) Department of Health (DOH), In-Home Services licensing Agencies giving personal care or homemaker help in clients' homes
West Virginia No state license No state license for private-pay companion and homemaker agencies None for private-pay No state license for private-pay; Medicaid personal care needs a CON
Wisconsin Medicaid/Medicare certification only Personal Care Agency (PCA) Medicaid certification Department of Health Services (DHS), Division of Quality Assurance No license; Medicaid certification only to bill Medicaid
Wyoming No state license No state license for non-medical home care Wyoming Department of Health, Healthcare Licensing and Surveys (HLS) No license for companion/homemaker-only care; 2+ health services need HHA

License names link to our guide where we have one, otherwise to the agency’s own page. Agency names and size thresholds are shortened here; state hubs give them in full.

Non-medical home care agency guides

All guides

  1. North Carolina home care agency license: in-home aide and companion services

    How North Carolina licenses non-medical home care: the DHSR home care agency license, the 2023 home assistance license, the $510 fee, training, staffing and Medicaid PCS.

    North Carolina · Non-medical home care agencyUpdated

  2. Rhode Island home care provider license: RIDOH licensure after the 2026 certificate-of-need change

    Opening a non-medical home care agency in Rhode Island: the 2026 certificate-of-need repeal, the $650 RIDOH license, accreditation, staffing and Medicaid limits.

    Rhode Island · Non-medical home care agencyUpdated

  3. South Carolina in-home care provider license: opening a non-medical home care agency

    How to license a non-medical in-home care agency with SC DPH under Regulation 60-122: the $1,000 fee, owner drug tests, insurance or surety bond, caregiver rules.

    South Carolina · Non-medical home care agencyUpdated

  4. Arkansas private care agency license: the Medicaid personal care route to in-home care

    How Arkansas licenses private care agencies for Medicaid personal care: Act 853 of 2025, the $1 million insurance rule, 40-hour aides, ADH inspections and enrollment.

    Arkansas · Non-medical home care agencyReviewed

  5. California home care organization license: starting a non-medical home care agency

    How CDSS licenses California home care organizations: who needs an HCO license, the $5,603 fee, insurance and bond, the HCS 281 packet, aide rules and 2029 fees.

    California · Non-medical home care agencyReviewed

  6. Colorado Class B home care agency license: opening a non-medical personal care agency

    How Colorado licenses non-medical home care: the CDPHE Class B license, what personal care workers may and may not do, the manager rules, the $2,720.30 fee and Medicaid.

    Colorado · Non-medical home care agencyReviewed

  7. Connecticut homemaker-companion agency registration: opening a non-medical home care business

    How Connecticut registers non-medical home care agencies with Consumer Protection: who registers, the $375 fee, the $10,000 bond, hiring and contract rules.

    Connecticut · Non-medical home care agencyReviewed

  8. Delaware personal assistance services agency license: opening a non-medical home care agency

    How Delaware licenses non-medical home care: the DHCQ personal assistance services agency license, $250 fee, 90-day initial license, background checks and task limits.

    Delaware · Non-medical home care agencyReviewed

  9. DC home support agency license: opening a non-medical personal care agency in the District

    How DC Health licenses home support agencies: the DC office rule, RN roles, the 90-day provisional license and five-client census, fees and insurance minimums.

    District of Columbia · Non-medical home care agencyReviewed

  10. Florida homemaker and companion registration: starting non-medical home care

    How Florida registers homemaker and companion providers with AHCA: what the registration allows, the $50.75 fee, Level 2 screening, dementia training and renewal.

    Florida · Non-medical home care agencyReviewed

  11. Georgia private home care provider license: one HFRD permit for sitter, personal care and nursing

    How Georgia licenses non-medical home care: who needs a Private Home Care Provider license, the RN rule, GAHLES filing, per-service fees and the provisional period.

    Georgia · Non-medical home care agencyReviewed

  12. Hawaii home care agency license: opening a personal care or homemaker agency

    How Hawaii licenses non-medical home care agencies under HAR 11-700: who needs the license, aide and supervisor rules, the OHCA application, the $1,500 fee and renewal.

    Hawaii · Non-medical home care agencyReviewed

  13. Illinois home services agency license: opening a non-medical home care agency

    How IDPH licenses non-medical home care in Illinois: who needs a home services agency license, the $1,500 fee, the 240-day provisional license, insurance and training.

    Illinois · Non-medical home care agencyReviewed

  14. Indiana personal services agency (PSA) license for non-medical home care

    How Indiana licenses non-medical home care under IC 16-27-4: who needs a PSA license, the $250 fee, the nine required policies, background checks and Medicaid waivers.

    Indiana · Non-medical home care agencyReviewed

  15. Kansas non-medical home care: the supportive care services home health agency license

    Licensing a Kansas non-medical home care agency: KDHE's supportive care license, administrator and manager rules, the $250 fee, allowed tasks and pending rule changes.

    Kansas · Non-medical home care agencyReviewed

  16. Kentucky personal services agency certification: opening a non-medical home care agency

    How Kentucky certifies non-medical home care agencies: who needs it, the three-client exemption, the $500 fee, dementia curriculum approval, hiring checks and renewal.

    Kentucky · Non-medical home care agencyReviewed

  17. Louisiana HCBS provider license: opening a personal care attendant agency

    How Louisiana licenses in-home personal care: the HCBS license and PCA module, Facility Need Review, the $50,000 line of credit, fees and the one-client survey.

    Louisiana · Non-medical home care agencyReviewed

  18. Maine personal care agency license: opening a non-medical home care agency under Ch. 129

    How Maine licenses personal care agencies: who needs a PCA license, the in-state office rule, the $500 fee, MBCC checks, PSS training, supervision and DLC backlogs.

    Maine · Non-medical home care agencyReviewed

  19. Maryland residential service agency (RSA) license for in-home personal care

    How OHCQ licenses Maryland residential service agencies: who needs an RSA license, the homemaker exemption, the application packet, RN supervision, training and Medicaid.

    Maryland · Non-medical home care agencyReviewed

  20. Minnesota basic home care license: starting a non-medical home care agency

    How Minnesota licenses non-medical home care: what the MDH basic license covers, the $2,100 temporary license, the five-day notice, the survey and renewal fees.

    Minnesota · Non-medical home care agencyReviewed

  21. Nevada personal care agency license: opening a non-medical home care business

    How Nevada licenses agencies providing in-home personal care: who needs the license, surety bond tiers, the $1,374 fee, required training and the HCQC application.

    Nevada · Non-medical home care agencyReviewed

  22. Starting a non-medical home care agency in New Hampshire: the HCSPA license

    How New Hampshire licenses non-medical home care agencies under He-P 822: personal care and homemaker classifications, the $25 or $250 fee, town sign-offs, staff rules.

    New Hampshire · Non-medical home care agencyReviewed

  23. New Jersey health care service firm registration for home care agencies

    How New Jersey registers non-medical home care agencies as health care service firms: the $500 fee, bond, insurance, RN supervisor, accreditation and renewal.

    New Jersey · Non-medical home care agencyReviewed

  24. New York licensed home care services agency (LHCSA): the license, the need test and the CON

    How New York licenses home care agencies: the LHCSA certificate of need through NYSE-CON, the county public need test, the $2,000 fee, PHHPC approval and registration.

    New York · Non-medical home care agencyReviewed

  25. Ohio nonmedical home health services license: opening a personal care agency

    How to get Ohio's ODH license for in-home personal care: which services need it, the $250 fee, the $20,000 bond, owner fingerprints and staff checks.

    Ohio · Non-medical home care agencyReviewed

  26. Oklahoma companion/sitter agency license: non-medical home care without hands-on care

    How Oklahoma licenses companion and sitter agencies through OSDH: the hands-off scope, $1,000 fee, ODH Form 1273, insurance minimums, OKSCREEN checks and renewal.

    Oklahoma · Non-medical home care agencyReviewed

  27. Oregon in-home care agency license: classifications, fees and the OHA survey

    How to license a non-medical home care agency in Oregon: the four OHA classifications, $2,000 to $3,000 fees, administrator rules, caregiver training hours and Medicaid.

    Oregon · Non-medical home care agencyReviewed

  28. Pennsylvania home care agency and home care registry license

    How Pennsylvania licenses non-medical home care: agency vs registry, the $100 fee, online-only applications, worker hiring files, competency rules and Medicaid.

    Pennsylvania · Non-medical home care agencyReviewed

  29. Tennessee personal support services agency (PSSA) license for non-medical home care

    How Tennessee licenses non-medical home care: the PSSA license from TDMHSAS or DDA, the 50% client rule, exemptions, required policies, worker checks, fees and renewal.

    Tennessee · Non-medical home care agencyReviewed

  30. Texas personal assistance services license: the HCSSA PAS category

    How HHSC licenses Texas non-medical home care: HCSSA personal assistance services category, companion exemption, administrator rules, $2,625 fee and the six-month survey.

    Texas · Non-medical home care agencyReviewed

  31. Utah personal care agency license: opening a non-medical home care agency

    How Utah licenses non-medical home care as a personal care agency under R432-725: who needs it, administrator and aide rules, DACS background checks and renewal.

    Utah · Non-medical home care agencyReviewed

  32. Virginia home care organization license for personal care services

    How to license a non-medical personal care agency in Virginia as a VDH home care organization: who is exempt, the $1,500 fee, reserve funds, RN supervision and insurance.

    Virginia · Non-medical home care agencyReviewed

  33. Washington home care agency license: the in-home services license, home care category

    How Washington licenses non-medical home care agencies via DOH: orientation class, $5,000 initial fee, initial survey, home care aide certification and DSHS contracts.

    Washington · Non-medical home care agencyReviewed

Beyond the state licenseEntity and EIN, caregiver pay rules, NPI, Medicaid or Medicare enrollment, EVV and background checks.Certificate of need by stateWhich states make home health, assisted living or adult day founders prove need before licensing.Non-medical home care vs home healthWhere personal care ends and skilled care begins, and which license each service needs.

Other care business types

All license types