Home Care Rates by State: Private Pay and Medicaid
Non-medical home care cost a median $35 an hour in 2025. What drives state differences, what Medicaid pays for personal care in four states, and how to price your agency.
By Caregiver Scheduling Team ·
The national median for non-medical in-home care was $35 an hour in 2025, up 3% from 2024, according to the CareScout Cost of Care Survey released in March 2026. State medians vary widely around that number. Medicaid rates for personal care are set by each state, are usually quoted per 15-minute unit, and in most states come in below the local private-pay rate.
How much does home care cost per hour nationally?
About $35 an hour for a non-medical caregiver, and about $90 an hour for a nurse in the home. Those are medians, so half the agencies surveyed charge more.
| Measure | Value | Source |
|---|---|---|
| Non-medical caregiver, national median hourly | $35 (2025) | CareScout |
| Annual cost at 44 hours a week | $80,080 (2025) | CareScout |
| Skilled nursing at home, median hourly | $90 (2025) | CareScout |
| Assisted living, median monthly | $6,200 (2025) | CareScout |
| Home health and personal care aide, median wage | $17.21 an hour (2025) | BLS Occupational Outlook Handbook |
The gap between the $17.21 median wage and the $35 median rate is where payroll taxes, workers’ comp, unbilled travel, office staff and margin live. See how much to charge for home care for the layer-by-layer math.
What do state Medicaid programs pay for personal care?
Anywhere from the high teens to the mid $40s an hour, depending on the state and program. South Dakota, for example, pays $11.17 per 15 minutes for agency personal care, or $44.68 an hour (fee schedule, July 1, 2026). Every state must now publish its fee-for-service rates on a public website under the Medicaid Access Rule, 42 CFR 447.203(b)(1), so you can check your state without a records request. Four examples, each from the state’s own rate document:
| State | Program and service | Published rate | Hourly equivalent | Effective |
|---|---|---|---|---|
| Washington | Home care agency provider, in-home personal care | $42.92 an hour (proposed, SPA 25-0023) | $42.92 | July 1, 2025 |
| Illinois | Community Care Program in-home service | $30.80 an hour, up from $29.63 | $30.80 | Jan 1, 2026 |
| Colorado | Personal care (T1019), outside Denver | $6.96 per 15 minutes | $27.84 | Oct 1, 2025 |
| Minnesota | Personal care assistance, 1:1 | $6.22 per 15 minutes | $24.88 | Jan 1, 2026 |
Three things to notice. Washington’s agency rate is above the national private-pay median. Illinois raised its rate about 4% in one year. Colorado pays $7.26 a unit inside Denver County, so even a single state has more than one number.
Most states bill personal care under HCPCS code T1019 or S5125, homemaker under S5130 and companion under S5135, in 15-minute units. Multiply the unit rate by four for the hourly equivalent. See Medicaid billing units.
Why do rates differ so much between states?
Mostly wages, then payer mix. Where the minimum wage is $16 or more and hospitals compete for the same workers, caregiver pay is higher and bill rates follow. Other drivers:
- Payer mix. In states where Medicaid funds most hours, private-pay rates tend to anchor closer to the Medicaid rate.
- Density. Rural routes mean more drive time per billed hour, and that cost lands in the rate.
- Regulation. Licensing, training hours, insurance minimums and EVV requirements all add cost. See caregiver training requirements by state.
- Metro spread. A state median hides a wide range. The largest metro is often $5 to $10 above the rural parts of the same state.
Our home care rates by state tool shows each state’s private-pay median and Medicaid personal care rate, with the source and the date we checked it.
Is the Medicaid rate enough to run on?
Sometimes, and only if your costs are known. Take Minnesota’s $24.88 an hour. Pay a caregiver $17.21, add 17% payroll burden and you are at $20.14 before travel, supervision or office overhead. That leaves under $5 an hour for everything else. At Illinois’ $30.80 the same math leaves about $10.
Before enrolling, run your fully loaded cost per billable hour and compare it to the published rate. Agencies that make Medicaid work usually do it with dense routes, tight authorization tracking and low administrative cost per visit. See how to become a Medicaid home care provider and private pay vs. Medicaid.
How should you use these numbers to price your agency?
- Calculate your own cost first. Wage, burden, non-billable time, overhead, margin.
- Compare to your metro, not the nation. Pull the CareScout figure for your metro and the Medicaid rate from your state’s fee schedule.
- Price inside your local range and be ready to say what is different about your service.
- Review once a year. CareScout publishes every spring and most states adjust Medicaid rates on July 1 or January 1.
How Caregiver Scheduling handles this
On Growth and up, each client’s authorized hours are checked as you schedule, and a week that would go over is flagged before you deliver unbillable units. Dense routes keep drive time per billed hour down. Invoices, timesheets and payroll built from the same verified visits are coming soon. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
How much does home care cost per hour? The 2025 national median for non-medical in-home care was $35 an hour, according to CareScout.
Is home care cheaper than assisted living? For part-time care, usually. At 44 hours a week home care already costs about $80,080 a year against $74,400 for assisted living, so full-time or round-the-clock care at home costs more.
Does Medicaid pay the same as private pay? Usually less. In the four states above the hourly equivalent ranges from $24.88 to $42.92.
Where do I find my state’s Medicaid personal care rate? On your state Medicaid agency’s fee schedule page. Federal rules require every state to publish fee-for-service rates online.