Midwest
Missouri Home Care, Home Health & Hospice Licensing
No Certificate of Need to clear, but each license type has its own survey and Medicaid enrollment queue.
RegulatorDHSS / BHCRS
Typical timeline3 to 9 months
License routes3
Delivery100% Virtual
Licensing in Missouri
Missouri needs no Certificate of Need for home health; RSMo 197.305 excludes it from CON review. All three service lines need a DHSS license from the Bureau of Home Care and Rehabilitative Standards, plus an on-site survey. To bill MO HealthNet, you also complete MMAC enrollment, which adds about nine months for In-Home Services.
Your regulator
Missouri Department of Health and Senior Services, Bureau of Home Care and Rehabilitative Standards (DHSS / BHCRS)
Official licensing page →License routes we cover in Missouri
Home Health Agency License
Agencies giving two or more home health services under a plan signed by a physician, NP, CNS, PA, or podiatrist; one service must be skilled nursing. RSMo 197.400-197.478, 19 CSR 30-26.010.
Hospice Certificate
Anyone providing palliative, end-of-life care to terminally ill patients and their families. RSMo 197.250-197.280, 19 CSR 30-35.010-30-35.030.
In-Home Services (IHS) Provider License
Agencies giving personal care, homemaker, chore, respite, or nurse-visit services to elderly or disabled adults, usually under DSDS authorization and MO HealthNet. 19 CSR 15-7.021, 13 CSR 70-91.010.
How we get you licensed
- 1Register your business
Form an LLC or corporation with the Missouri Secretary of State and get an EIN. DHSS needs proof of registration.
- 2Assemble the application packet
Download the form at health.mo.gov/safety/homecare/appsforms.php. Include the application, Ownership Disclosure statement, business proof, policies, staff credentials, insurance, and background checks. Mail to BHCRS, PO Box 570, Jefferson City, MO 65102-0570.
- 3Pay the state license fee
Home Health Agency: $600 nonrefundable, plus $600 each year at renewal (RSMo 197.410, 197.415). Hospice: $250-$750 sliding scale set by DHSS with the hospice advisory council (RSMo 197.254). In-Home Services: fee unpublished; confirm with BHCRS at 573-751-6336.
- 4Pass the pre-licensure survey
After DHSS accepts the application, a state surveyor inspects your office, policies, and staff credentials. DHSS issues a deficiency list; you have ten days to submit a correction plan.
- 5Get licensed and enroll in Medicare or Medicaid
After passing, DHSS issues your license. For Medicare, file CMS-855A with your MAC and pass a CMS certification survey. To bill MO HealthNet for In-Home Services, submit a proposal to MMAC (nine-month enrollment).
- 6Meet ongoing compliance rules
Register all direct-care workers with the Family Care Safety Registry (RSMo 192.2495) before first contact, use approved EVV for Medicaid visits, and complete dementia training.
How long does it take?
Typical time to a live license in Missouri. Times assume a complete, accurate application; missing items add time.
- Home Health or Hospice license
- 3 to 6 months
- Adding Medicare certification
- 2 to 4 months more
- In-Home Services (Medicaid billing)
- About 9 months
Key Missouri requirements
- Offer at least two home health services, one being skilled nursing (RSMo 197.400; 19 CSR 30-26.010).
- Rule 19 CSR 30-26.010 adopts 42 CFR 484, so state-licensed agencies meet full federal CoPs even without Medicare.
- Register every direct-care worker with the Family Care Safety Registry and clear them first (RSMo 192.2495, formerly RSMo 660.317, renumbered 2014).
- Medicaid personal care and home health visits need EVV via an MMAC-approved vendor; only a supervisor or administrator makes manual edits.
- The IHS day-to-day supervisor must be 21 or older with a Missouri RN license, a Missouri LPN license plus one year of care experience, a bachelor's degree, or two years of experience with elderly or disabled adults (19 CSR 15-7.021).
- All direct-care staff at home health agencies complete dementia training (disease, communication, behavior, daily living, family issues) at orientation and annually (19 CSR 30-26.010).
Traps that catch new owners
- A DHSS In-Home Services license does not enroll you with MMAC or allow MO HealthNet billing. MMAC's proposal, site visit, contract, and enrollment are separate, with their own nine-month queue.
- DHSS won't schedule the survey until your packet is complete. Missing items delay you by weeks or months, and the survey-within-one-year clock still runs from initial submission.
- Non-medical companionship or housekeeping needs no license, but adding one personal care task (bathing, dressing, medication reminders) triggers In-Home Services licensure and MMAC enrollment; noncompliance means immediate Medicaid removal.
Missouri licensing packages
Fixed price, agreed in writing before any work begins. Each package is prepared and submitted for you, fully online.
Missouri licensing FAQs
Does Missouri require a Certificate of Need for home health or hospice?
No. Missouri's CON law (RSMo 197.300-197.366) excludes home health from CON review (RSMo 197.305(9)(f)). Hospice and in-home services are also exempt. You can apply for a DHSS license without CON approval.
Can I run a personal care or homemaker agency without a state license?
Only if you stick to pure companionship, housekeeping, and chore tasks. Once workers help with daily living (bathing, dressing, grooming), you fall under In-Home Services licensure through DHSS and must complete MMAC enrollment to bill MO HealthNet.
How long from application to first billable visit?
For a Home Health Agency seeking a state license and Medicare, budget five to nine months. For In-Home Services billing MO HealthNet, MMAC says provider numbers usually issue about nine months after a complete proposal, and longer if it has gaps.
Ready to launch in Missouri?
Book a free discovery call and we’ll map exactly what your Missouri licensing will take, and what it will cost.
Book a Free Discovery Call
