Missouri · Checked October 22, 2026
Non-medical home care is not state-licensed in Missouri — but the lanes around it are regulated, and the skilled door is a different license.
Checked in part. Absence claim: DHSS's own Home Care page scopes its licensure to home health/hospice and the licensure statute (§§197.400-197.475) defines only that skilled category; no explicit .gov sentence 'private duty needs no license' was found in this pass, so marked partial. Medicaid/EVV and skilled-fee facts are primary. Anything the state does not publish is printed as "Not published" below — never filled from blogs or consultancy tables. Confirm on the agency page before you budget.
| Item | Missouri |
|---|---|
| License / registration | No state license for private-pay non-medical / private-duty home care (DHSS licenses home health agencies and hospices only) |
| Issued by | Missouri Department of Health and Senior Services (DHSS), Bureau of Home Care and Rehabilitative Standards; Missouri Department of Social Services (DSS) / MO HealthNet MMAC for Medicaid in-home services contracts — official page |
| Application / initial fee | Not published — No license, hence no fee, for private-pay personal care/companionship. The $600 figure in RSMo §§197.410/197.415 is the HOME HEALTH agency license fee, not a non-medical fee. |
| Renewal | Not applicable to non-medical private pay. Home health renewal is $600/year (RSMo §197.415). |
| Surety bond | No state bond minimum found in the published rules |
| Liability insurance | State sets no minimum for private-pay non-medical home care |
| Timeline | Not published — no license application for the non-medical lane |
| Administrator | No state administrator requirement for private-pay non-medical care. Medicaid in-home services providers must meet DSS/MMAC contract standards, background-check staff under RSMo §192.2495 (applies to in-home services providers under contract with DSS), and follow DHSS Division of Senior and Disability Services care-plan authorization. |
| State extras | For Medicaid work only: EVV vendor/aggregator costs, Family Care Safety Registry background checks, MMAC enrollment. No state fee for private-pay opening. |
| Service | Under this license |
|---|---|
| Companionship & supervision | Covered |
| Homemaker help | Covered |
| Hands-on personal care | Covered |
| Live-in / 24-hour care | Covered |
| Transportation | Covered |
| Skilled nursing or therapy | Home health license required |
Skilled lane is licensed: a 'home health agency' providing 2 or more home health services (nursing, PT, speech, OT, home health aid, medical social service) on a part-time/intermittent basis under a physician-signed plan needs a DHSS license (RSMo §197.400). Aide-only personal care under a Medicaid contract is enrollment, not licensure.
Home health agency license via DHSS: $600 application fee (§197.410) and $600 annual renewal (§197.415), survey at least every 36 months (every 12 months in the first 36 months).
Enroll/contract as an In-Home Services provider with DSS Missouri Medicaid Audit and Compliance (MMAC): Title XX in-home services approval first, then a Title XIX (Medicaid) Personal Care participation agreement (13 CSR 70-91.010); services authorized by DHSS DSDS. Consumer-Directed Services is the separate self-directed model.
13 CSR 70-3.320 and DSS EVV pages require EVV for Medicaid personal care/advanced personal care, homemaker/chore, in-home respite and home health; providers must contract with an EVV vendor and register with the state EVV Aggregator (Sandata).
The state fee above is one line of the real total. Run the true-cost calculator with Missouri selected — it adds the bond premium, insurance class, screening and the payroll runway your first hires create.
This page is information, not legal advice. Confirm before you file: the agency — not this page — decides your application.
The free checkers give you the verdict and the number. The Kit gives you the working papers: your state's application packet walked through in filing order, the policies-and-procedures binder spec (what your binder must contain — never a boilerplate binder), the administrator self-audit, the insurance & bond spec sheet, the Medicaid gate map, the franchise-vs-independent 10-year worksheets, and the payroll-runway planner.
$49 one-time payment
Included in the $49 HomeCareLicenseCheck Kit
