Compliance
Do You Need a License to Run a Non-Medical Home Care Agency?
In most states, yes. How the license depends on the services you offer, what six states actually require, what applications ask for, and how to check your state.
Do you need a license to run a home care agency in Missouri?
Last verified October 17, 2026 · All Missouri resources
No. Missouri does not require a state license for non-medical home care agencies. Missouri licenses home health agencies, which provide two or more listed home health services (nursing, therapy, home health aide, or medical social service) under a written plan of treatment signed by a clinician. Companion and non-medical personal care are not listed services, so a private-pay non-medical agency generally needs no state license. Agencies that serve Medicaid in-home services clients must contract with the Department of Social Services and meet 19 CSR 15-7.021.
What are the key facts?
| License required | No |
|---|---|
| Regulator | Missouri Department of Health and Senior Services (DHSS) |
| Rule | RSMo 197.400 (home health definition); 19 CSR 15-7.021 (Medicaid in-home services) |
What should you confirm with the state?
The training and background check rules shown apply to state-contracted (Medicaid) in-home services providers and licensed home health agencies; a private-pay non-medical agency may not be covered. Fingerprints are one way to meet the background check requirement, not the only way. Confirm that no license is needed for your services with the Missouri Department of Health and Senior Services.
What should you budget for?
The license fee is a small part of startup cost. Insurance, payroll for your first caregivers before clients pay, and office staff usually cost far more. Use the bill rate calculator to check your pricing covers it, and the intake form and care plan templates for the paperwork inspectors ask to see.
Sources
More for Missouri
Agency licensing by state: other states
Related guides
General
How to Start a Non-Medical Home Care Agency: Step by Step
Ten steps to open a non-medical home care agency, from services and state licensing to insurance, hiring, payers, systems and first clients, with real fees.
Compliance
How Long Does It Take to Get a Home Care License?
Plan on 2 to 6 months in most licensing states. Statutory review clocks are 60 to 90 days, but they start only when your application is complete.
General
Home Care Agency Startup Costs: A Line-by-Line Budget
What it costs to open a non-medical home care agency: real state license fees, insurance minimums, office, hiring, software and the working capital most owners underestimate.
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