How do I start a Medicaid home care agency?
In short: form the business, learn which Medicaid program and service you will offer, get your state license, pass background checks, enroll with Medicaid, set up EVV and billing, and hire trained caregivers. Rules differ by state, so start with your state Medicaid agency.
Steps differ by state, but the path is similar everywhere:
- Choose your service. Personal support (home care), case management, adult day health and personal care homes each have different rules.
- Form the business. Register with your state, get an EIN, open a bank account, and buy liability insurance.
- Find your state’s license. Many states license home care agencies; check the health department.
- Complete background checks. Owners and staff usually need fingerprint-based checks.
- Write your policies: client rights, complaints, emergencies, infection control.
- Enroll with Medicaid. Each state has its own portal and waiver programs.
- Set up EVV. Federal law requires it for Medicaid personal care.
- Set up scheduling, payroll and billing.
- Hire and train caregivers to your state’s hours.
- Plan your cash. Medicaid pays after you bill, so you need working money.
A warning: some Medicaid waivers are not open to new providers all the time, and some want you to be in business for a period first.
The best first call is to your state Medicaid agency and the licensing office. Then talk to two owners who started in the last few years.
In Georgia, see the next question.
Sources
- Electronic Visit Verification (EVV) · Medicaid.gov / CMS
- Private Home Care Program · Georgia Department of Community Health
- Georgia Step-by-Step Licensing Guide for Medicaid Waiver Providers · Waiver Consulting Group (private consultancy, secondary source)
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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