Companion Care vs. Personal Care: What's the Difference for Your Agency?
Companion care is hands-off help; personal care is hands-on help with ADLs. The line decides your license, training hours, insurance and rates.
By Caregiver Scheduling Team ·
Companion care is hands-off help: company, meals, light housekeeping, errands and rides. Personal care is hands-on help with activities of daily living such as bathing, dressing, toileting, transfers and eating. The line matters because most states regulate hands-on care more strictly, require more caregiver training, and insurers price it higher. Offering even one personal care task can move your agency into the stricter category.
What’s the difference between companion care and personal care?
The test is touch. If the caregiver’s hands are on the client to help them bathe, dress, move or eat, it’s personal care. Everything else is companion or homemaker care.
| Topic | Companion or homemaker care | Personal care |
|---|---|---|
| Typical tasks | Company, meals, housekeeping, laundry, errands, transportation, medication reminders | All companion tasks plus bathing, dressing, grooming, toileting, transfers, feeding |
| Touch | Hands-off | Hands-on |
| State oversight | Registration or none in some states | Licensed in most states |
| Caregiver training | Less | More, sometimes a certificate or exam |
| Liability insurance | Lower | Higher |
| Common Medicaid codes | S5130 homemaker, S5135 companion | T1019 personal care, S5125 attendant care |
Florida shows how a state writes the line into law. Its statute defines a homemaker and a companion, and says each “may not provide hands-on personal care to a client” (Fla. Stat. 400.462).
Does the difference change what license you need?
Usually yes. Many states let you provide companion or homemaker services with a registration or no license at all, but require a license once you touch the client.
In Florida, homemaker and companion providers register with the Agency for Health Care Administration for a $50 fee every two years (Fla. Stat. 400.509). Hands-on care falls under the licensed home health agency or nurse registry rules instead. See do you need a license for non-medical home care? and the licensing directory.
Does the FLSA “companionship” exemption apply to companion care?
Not for an agency. Since 2015, third-party employers cannot claim the companionship exemption, so every caregiver you employ is owed minimum wage and overtime (DOL Fact Sheet 79A).
The exemption still exists for families who hire directly. Federal rules define companionship services as fellowship and protection, with “care” allowed only if it stays under 20 percent of hours worked each week (29 CFR 552.6). That 20 percent line is a useful definition of where companion care ends, even though it has no effect on your payroll. See home care overtime rules.
How much more training does personal care require?
It depends on the state, and the spread is wide.
| State | Companion or homemaker aide | Personal care aide (agency employee) |
|---|---|---|
| California | 5 hours before client contact, 5 hours a year, same as personal care | 5 hours entry-level (2 orientation, 3 safety) plus 5 hours a year (HSC 1796.44) |
| Washington | Limited exemptions exist | 75 hours (2 orientation, 3 safety, 70 basic) and certification within 200 days of hire (RCW 74.39A.074, DSHS summary) |
California’s law covers any affiliated home care aide, so both roles train the same. Washington’s 75-hour rule and 12 hours of annual continuing education apply to workers who provide personal care. Look up your state in the training requirements directory and caregiver training requirements by state.
Should you charge more for personal care?
Yes, in most markets. Personal care costs you more to deliver: more training hours, higher liability premiums, and often a more experienced caregiver.
The national benchmarks no longer split the two. The 2025 CareScout Cost of Care Survey merged homemaker and home health aide rates into one “non-medical caregiver” category with a national median of $35 an hour. Caregiver pay sits far below that: the BLS median for home health and personal care aides was $17.21 an hour in May 2025. A modest personal care premium covers the extra cost without complicating the rate sheet.
Medicaid rates don’t always reward hands-on care. South Dakota’s 2025 rate analysis lists homemaker (S5130) and personal care (T1019) at the same $44.08 an hour (SD DSS). Check your own fee schedule. See how much to charge for home care.
How do you keep caregivers inside scope?
Write the tasks into the care plan and make the caregiver’s task list match. Scope creep is the common failure: a companion client asks for help in the shower, the caregiver says yes, and now you are delivering personal care without the license, training or insurance for it.
- Put the exact task list in the plan of care and the service agreement.
- Train caregivers to say “I’ll ask the office” when a client requests a hands-on task.
- Reassess when needs change, and update the plan, the rate and the caregiver together.
- Neither service includes medication administration. See can caregivers give medication?
How Caregiver Scheduling handles this
Care tasks live on each client record and appear as a checklist in the caregiver app at every visit, so a companion-only client never shows a bathing task and a personal care client always does. When a care plan changes, the recurring schedule and task list update together. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
Is companion care the same as homemaker care? They overlap. Companion care is company and supervision; homemaker care is household tasks. Most states and payers treat them as one hands-off category.
Can companion caregivers help with bathing? Not if your agency is registered or licensed only for companion or homemaker services. Bathing is personal care in every state’s definition.
Do agencies get the FLSA companionship exemption for companion-only clients? No. Since 2015 only households that employ the caregiver directly can claim it. Agencies pay minimum wage and overtime for all hours.
This article is general information, not legal advice. Check your state’s licensing and training rules.