North Carolina · Checked October 22, 2026
Your license is the Home Care Agency License, issued by North Carolina Department of Health and Human Services, Division of Health Service Regulation (DHSR), Acute and Home Care Licensure and Certification Section.
| Item | North Carolina |
|---|---|
| License / registration | Home Care Agency License |
| Issued by | North Carolina Department of Health and Human Services, Division of Health Service Regulation (DHSR), Acute and Home Care Licensure and Certification Section — official page |
| Application / initial fee | $510 — Annual license fee of $510, set in statute (the state does not return it) — G.S. 131E-138(c). Each site providing home care services must be separately licensed. |
| Renewal | $510 |
| Surety bond | No state bond minimum found in the published rules |
| Liability insurance | State sets no minimum |
| Timeline | DHSR gives an applicant 12 months from receipt of the initial application and fee to complete all requirements and obtain the license, and requires an initial survey. DHSR does not publish a typical approval time; the often-quoted 90–180 days comes from secondary guides, not the state. |
| Administrator | Each site must designate an agency director with administrative authority who meets at least one path in 10A NCAC 13J .1001(b): (1) a health care practitioner as defined in G.S. 90-640(a); (2) at least 2 years of supervisory/management experience in home care or another provider licensed under G.S. 131E or 122C; or (3) a bachelor's degree in health, business or public administration plus at least 1 year of supervisory/management experience in home care or another licensed health care program. Separately, an applicant who has not previously owned/operated a home care agency must complete DHSR-approved training on licensure and the rules before a license issues (G.S. 131E-140). |
| State extras | DHSR-approved new-owner licensure training is mandatory for first-time owners/operators (course price is set by approved training providers, not published by the state, so no amount is shown). Aides providing personal care must meet 10A NCAC 13J competency/training requirements, and in-home aides are listed through the NC Health Care Personnel Registry system. |
| Service | Under this license |
|---|---|
| Companionship & supervision | Covered |
| Homemaker help | Covered |
| Hands-on personal care | Covered |
| Live-in / 24-hour care | Not covered by this license |
| Transportation | Not covered by this license |
| Skilled nursing or therapy | Home health license + a gate (see below) |
One home care license covers the services the agency is approved for — in-home aide (personal care), nursing, therapies and other 10A NCAC 13J services — each with its own supervision and competency rules; an agency may only provide the home care services listed on its license. Separately, 'home assistance services providers' (housekeeping/companionship-type help) were added to the licensure statute — check DHSR for which model a pure-companionship business falls under before assuming it is unlicensed.
Nursing and therapy services can be listed on the same DHSR home care license, but developing a home HEALTH agency service is gated: North Carolina's Certificate of Need law treats home health agency services by county, so Medicare-certified home health entry needs a CON — the ordinary home care (in-home aide/personal care) license does not.
Certificate of Need gates the home health (skilled/Medicare-certified) lane by county in North Carolina. No CON is required for the home care license used for in-home aide / personal care services.
Hold the DHSR home care license, then enroll in NC Medicaid through NCTracks. Personal Care Services (PCS) are delivered under NC Medicaid Clinical Policy 3L after an independent assessment of the beneficiary; agencies contract with NC Medicaid Direct / managed care plans as applicable.
NC Medicaid EVV for PCS and home health runs through Sandata (state system) or an approved alternate EVV feeding the state aggregator.
The state fee above is one line of the real total. Run the true-cost calculator with North Carolina 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
