Texas Personal Assistance Services (PAS) license — Fixed-Price Application Support
$2,495.00
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Texas Home Care, Home Health & Hospice Licensing
Texas has no Certificate of Need and no enrollment moratorium — new HCSSA applications are accepted year-round through the TULIP portal, making it one of the most accessible home care markets in the country.
RegulatorHHSC
Typical timeline3 to 6 months from application submission to active license for PAS and Licensed Home Health. L&CHHS and Hospice agencies seeking Medicare certification typically add another 2 to 4 months for the CMS certification step, putting the full timeline at 5 to 10 months. Because HHSC is currently not conducting initial Medicare certification surveys, use of a CMS-approved accrediting organization is effectively required for the Medicare certification phase and can significantly influence the total timeline.
License routes4
Delivery100% Virtual
Licensing in Texas
Every home care, home health, and hospice provider in Texas must hold a Home and Community Support Services Agency (HCSSA) license issued under Texas Health & Safety Code Chapter 142 and the rules in 26 Texas Administrative Code Chapter 558. Texas does not impose a Certificate of Need or a licensure moratorium, so new applications are accepted on a rolling basis through the Texas Unified Licensure Information Portal (TULIP). Unlike many states, the same HCSSA framework covers everything from non-medical personal attendant care to Medicare-certified skilled home health and hospice — the service category selected on the application determines what the agency is authorized to provide.
License routes we cover in Texas
Personal Assistance Services (PAS)
Non-medical agencies providing attendant and personal care services (activities of daily living) to clients in homes or assisted living facilities; does not require nurses on staff.
Licensed Home Health Services (LHHS)
Agencies providing skilled nursing and therapy under physician orders to clients who do not qualify for or elect Medicare home health benefits; state-licensed only, not federally certified.
Licensed and Certified Home Health Services (L&CHHS)
Agencies that hold both the Texas state HCSSA license and federal CMS certification, enabling billing of Medicare and Medicaid managed care plans (STAR+PLUS, STAR Kids) for skilled home health services.
Hospice Services
Agencies providing end-of-life palliative care; available as Medicare-certified (requires federal Conditions of Participation survey) or non-Medicare; governed by a distinct subchapter of 26 TAC Chapter 558.
How we get you licensed
- 1Form the business entity and satisfy state prerequisites
Register the legal entity (LLC or corporation) with the Texas Secretary of State and obtain good-standing status with the Texas Comptroller of Public Accounts. Both registrations must be active and in good standing before HHSC will process an HCSSA application.
- 2Designate and train required personnel
Appoint a qualified administrator and alternate administrator. For PAS-only agencies, the administrator may qualify with a high school diploma or GED plus: (A) at least one year of experience or training in caring for individuals with functional disabilities, or (B) two years of full-time college study in a health-related field. For Licensed Home Health, L&CHHS, or Hospice, the administrator must be a licensed physician, RN, licensed social worker, licensed therapist, or licensed nursing home administrator with at least one year of management or supervisory experience in a health-related setting — or, alternatively, must hold a high school diploma or GED with at least two years of management or supervisory experience in a health-related setting. All required personnel must complete the HHSC Pre-Survey Computer-Based Training (CBT) through apps.hhs.texas.gov and score at least 80% on each module quiz; signed completion certificates must accompany the application. Home health and hospice agencies must also designate a qualified supervising nurse and alternate supervising nurse who complete the CBT.
- 3Prepare and submit the application through TULIP
Log into the Texas Unified Licensure Information Portal (TULIP) at tulip.hhs.texas.gov and complete HHSC Form 2021 (HCSSA License Application). Upload all required documents — including CBT completion certificates, organizational documents, and ownership disclosures — as required by the TULIP document checklist. Pay the non-refundable initial license fee (currently $2,625 for a three-year parent agency or branch license). Per 26 TAC §558.31, HHSC has up to 45 days to review a complete application; if deficiencies are identified, the applicant has 30 days to respond or the application is denied, after which HHSC has an additional 45 days to issue or deny the license.
- 4Admit at least one client and notify HHSC of survey readiness
Once the initial HCSSA license is issued (valid for three years), the agency must admit at least one client and begin providing services within six months. No later than six months after license issuance, submit HHSC Form 2020 (Notification of Readiness for Initial Survey) to the appropriate regional survey office listing client names, admission dates, and service categories. L&CHHS agencies seeking Medicare certification must have provided skilled services to at least 10 qualified patients, with at least seven of those patients active on the day of the survey, before requesting the certification survey.
- 5Complete the HHSC initial health survey
HHSC surveyors conduct an on-site inspection evaluating client records, personnel records, agency policies, and actual service delivery against the standards in 26 TAC Chapter 558. The administrator or alternate must be present for entrance and exit conferences; the supervising nurse must be available in person or by phone. Agencies may alternatively pursue accreditation through CHAP, ACHC, or The Joint Commission, whose combined state licensure and accreditation surveys can satisfy this requirement.
- 6Pursue Medicare certification (L&CHHS and Hospice only)
As of the current date, HHSC is not conducting initial Medicare certification surveys due to CMS workload prioritization directives. Accordingly, L&CHHS and Hospice agencies seeking Medicare certification must work with a CMS-approved accrediting organization (ACHC, CHAP, or The Joint Commission) that holds CMS deeming authority to conduct the initial certification survey. A single combined survey through such an accreditor satisfies both the HHSC initial health survey and the CMS certification requirement. Medicare billing may begin only after CMS issues the certification number.
Key Texas requirements
- Texas Secretary of State registration and Texas Comptroller of Public Accounts good-standing status are mandatory before HHSC will accept an HCSSA application.
- All administrators, alternate administrators, supervising nurses, and alternate supervising nurses must complete the multi-module HHSC Pre-Survey CBT (scoring at least 80% per module) and submit signed certificates with the application.
- Administrator and alternate administrator qualifications differ by service category: PAS allows a high school diploma/GED plus one year of experience or training in caring for individuals with functional disabilities (or two years of full-time college study in a health-related field); home health and hospice require either a licensed clinical professional or nursing home administrator with one year of supervisory experience, or a high school diploma/GED with two years of management or supervisory experience in a health-related setting.
- The agency must admit at least one client and submit Form 2020 (Notification of Readiness for Initial Survey) within six months of the initial license issuance date.
- The initial license fee is $2,625 (non-refundable) for a three-year parent agency or branch license; renewal also runs $2,625 for three years.
- L&CHHS agencies must demonstrate compliance with federal Medicare Conditions of Participation in addition to state standards; because HHSC is currently not conducting initial Medicare certification surveys, a CMS-approved accrediting organization survey is required before Medicare billing can begin.
Traps that catch new owners
- Failing to admit a client within six months of license issuance is one of the most common early compliance failures: HHSC requires at least one active client before it will schedule or conduct the initial survey, and the six-month clock does not pause.
- Submitting copied or generic policy and procedure manuals is a leading cause of survey deficiencies and enforcement action; HHSC does not provide a template, and surveyors verify that policies match actual agency operations and address every required topic under 26 TAC Chapter 558.
- Confusing the Licensed Home Health and Licensed-and-Certified categories: selecting LHHS when the agency intends to bill Medicare is a fundamental error that requires a costly change-of-category process; agencies must select the L&CHHS (certified) category at the time of initial application if Medicare participation is the goal.
- Assuming HHSC will conduct the initial Medicare certification survey: HHSC is currently not performing initial Medicare certification surveys per CMS workload directives, so agencies must budget time and cost for engagement with a CMS-approved accrediting organization (ACHC, CHAP, or The Joint Commission) to obtain Medicare certification.
Texas licensing packages
Fixed price, agreed in writing before any work begins. Each package is prepared and submitted for you, fully online.
Texas Licensed and Certified Home Health Services license — Fixed-Price Application Support
$4,495.00
View detailsTexas licensing FAQs
Does Texas require a Certificate of Need (CON) or have any moratorium on new home health or hospice applications?
No. Texas does not have a Certificate of Need law for home care, home health, or hospice services, and HHSC does not impose enrollment moratoria on new HCSSA applications. Applications are accepted on a rolling basis through TULIP year-round.
Can one HCSSA license cover multiple service categories — for example, both personal assistance and skilled home health?
Yes. A single HCSSA license can authorize multiple service categories selected at the time of application. The required personnel, training, and compliance standards apply separately for each category selected, so an agency offering both PAS and licensed home health must meet the staffing and policy requirements for both.
Is accreditation (ACHC, CHAP, or Joint Commission) required, or is it optional?
For the state HCSSA initial health survey, accreditation is technically optional — an agency can request a direct HHSC survey. However, for agencies seeking Medicare certification, working with a CMS-approved accreditor that holds deemed status is effectively required because HHSC is currently not conducting initial Medicare certification surveys per CMS workload directives. A single combined survey through such an accreditor satisfies both the HHSC initial health survey and the CMS certification requirement.
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