Personal care and services · LLC guide · updated
How to start a home health care business and form its LLC
A medical home health care LLC needs a state home health agency license in most states, and to bill Medicare it must meet CMS Conditions of Participation through a state survey or accreditation. Some states also require a certificate of need. As of October 2026.
To start a home health care business, form an LLC in your state and get its EIN. Then line up what this business needs on top of that: home health license, NPI, Medicare certification, and professional liability. Insurance to plan for: general liability and workers' compensation.
Registered agent service, provided through our partner Registered Agents Inc, is optional: $74.25 a year, the same at renewal. Questions first? Ray or Vinny picks up at (954) 470-8356.
- EIN
- Home health license
- NPI
- Medicare certification
- Professional liability
Home Health Care Agency businesses in the U.S.
Source: U.S. Census Bureau, County Business Patterns 2022 (NAICS 621610) and U.S. Census Bureau, Nonemployer Statistics 2022 (NAICS 62161), the latest U.S. totals.
Why home health care agency owners form an LLC
A home health agency sends nurses and therapists into patients' homes to provide skilled medical care, which is different from non-medical home care. Clinical errors, patient falls and billing mistakes are the major risks. An LLC holds the state license, the Medicare enrollment and the clinical staff payroll.
Clinical errors
Medication, wound care and missed visits lead to malpractice claims.
Patient falls
Falls during transfers and therapy visits.
Billing errors
Medicare and Medicaid billing mistakes can mean repayments and penalties.
An LLC keeps the company's debts and claims away from your personal assets when you run it as its own business: its own bank account, contracts signed in its name, and no mixing of money. It does not cover your own negligence, and lenders often ask for a personal guarantee. Insurance comes first.
If your license is personal (agent, producer, preparer, notary, contractor qualifier), check whether your state requires a professional LLC (PLLC) and whether the license board lets the company hold the license or receive the fees. A lawyer in your state can confirm.
Licenses and registrations for a home health care agency
Federal items link to the agency's own page. State and local rules vary, so pick your state at the top for your state's business portal. Tick items off as you go; the list remembers your progress on this device.
- We do thisForm the LLC and get its EINAlmost every registration above asks for the company's legal name and EIN, so this comes first. We file the LLC with your state for $123.75 plus the state fee, and can get the EIN for $41.25; the IRS also issues it free online.
Insurance and taxes to plan for
Insurance
- Professional liability
Covers clinical malpractice claims.
- General liability
Covers injuries and property damage in patients' homes.
- Workers' compensation
Lifting and driving injuries are common.
Taxes
- Clinical staff are usually employees
Agencies that schedule and supervise nurses and aides should run them on payroll. IRS / agency page
- Payroll taxes
Payroll is the largest cost; budget employer taxes into your plan.
Skilled nursing and therapy need a home health license and often Medicare certification; companion and personal care do not. Pick the services first so the LLC's purpose and license match. This is a common pattern, not advice for your situation; an attorney in your state can tell you whether it fits.
Forming the LLC itself: 7 steps in every state
- 1. Check the name
- 2. Name a registered agent
- 3. File with the state
- 4. Sign an operating agreement
- 5. Get an EIN
- 6. Open a bank account
- 7. Keep it in good standing
The filing office, fee and yearly report change by state. Open your state's step-by-step guide.
What it costs to form a home health care agency LLC
| Cost | File it yourself | With Vermilion Vitez |
|---|---|---|
| State filing fee (paid to the state) | $35 to $520 | $35 to $520 |
| Filing service, operating agreement included | $0 | $123.75 |
| EIN from the IRS | $0 | $0 yourself, or $41.25 if we get it |
| Registered agent service through our partner Registered Agents Inc, per year (optional) | $0 if you serve yourself | $74.25 |
State fees as charged at our checkout. Industry licenses, permits, bonds and insurance above are separate and set by each agency. Checkout shows the card processing fee before you pay.
Frequently asked questions
What is the difference between home health and home care?
Home health provides skilled medical care, such as nursing and therapy, under a state license and often Medicare certification. Home care is non-medical help with daily living.
Do I need Medicare certification?
Only to bill Medicare. Certification requires your state license where one exists and a state survey or accreditation against the Conditions of Participation in 42 CFR Part 484.
Does my state require a certificate of need?
Some states do for new home health agencies. Check with your state health department before you lease space or hire.
What insurance does a home health agency need?
Professional liability, general liability and workers' comp.
How much does it cost to form an LLC for a home health care agency?
Your state's filing fee ($35 to $520 depending on the state) plus $123.75 if we file it, with the operating agreement included. Industry licenses, bonds and insurance are extra and set by each agency.
Is this page legal or tax advice for my home health care agency?
No. It summarizes public rules in general terms, with links to the agencies that set them. For your situation, talk to a licensed attorney or CPA. For help with the filing itself, book a free call with us.
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Have us file your Home Health Care Agency LLC
$123.75 plus your state's filing fee, with the operating agreement included. Checkout shows the full total, card processing fee and all, before you pay.
Rather talk first? Call Ray or Vinny at (954) 470-8356.