How to start a home health agency in Colorado

Colorado requires a Home Care Agency license — Class A from Colorado Department of Public Health and Environment, Health Facilities and Emergency Medical Services Division to operate a home health agency. Fee: $3,709.49. Processing time: Complete application, attachments and fees must be submitted at least 90 calendar days before the planned start date.

License required

Yes

License

Home Care Agency license — Class A

Issuing agency

Colorado Department of Public Health and Environment, Health Facilities and Emergency Medical Services Division

Fee

$3,709.49

Fee details

Initial Class A license application $3,709.49 (fee schedule 7/1/2026–6/30/2027). Each provisional license term costs 15% of the initial fee. Adding a branch $247.30; adding a workstation $61.83.

Renewal

Class A renewal base fee $1,916.58, plus $247.30 per branch and $61.83 per workstation; add $123.65 (50–99 annual admissions) or $247.30 (100+). Medicare/Medicaid-certified agencies deduct $100 and accredited (deemed) agencies take 10% off the base fee. Renewal is due 60 days before expiration; late fees run 10%–75% and the license is void at 90 days past expiration.

Processing time

Complete application, attachments and fees must be submitted at least 90 calendar days before the planned start date.

Accreditation

Optional; accredited agencies receive a 10% accreditation-deeming discount on the renewal base fee.

Survey and inspection

On-site inspections; a second or later revisit for the same deficiency is charged 100% of the applicable initial or renewal fee.

Medicare certification

CDPHE also handles Medicare/Medicaid certification; certified agencies get a $100 renewal discount.

Regulation

6 CCR 1011-1 Chapter 2 (General Licensure Standards) and Chapter 26 (Home Care Agencies); Chapter 24 (Medication Administration)

1. Submit a Letter of Intent (LOI) to CDPHE
2. Receive emailed instructions and apply through the COHFI online system
3. Submit the completed application, attachments and fee at least 90 days before start-up
4. Operate under a provisional license during initial licensure (Chapter 2 Part 2.4; Chapter 26 Part 4.3)
5. Pass on-site inspection

Program

Health First Colorado (Colorado Medicaid)

Enrollment portal

Colorado interChange Provider Web Portal (Gainwell)

Fiscal agent

Gainwell Technologies (Colorado interChange MMIS)

Application fee

HCPF lists the CY2026 fee as $750 for institutional providers, charged on new enrollments, revalidations and new locations. HCPF also has a process for paying a previously waived fee. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

HCPF names its high-risk types, all for new enrollments: doulas, DME suppliers, home health agencies, hospices, lactation providers, skilled nursing facilities, personal care agencies under the state plan, certain opioid treatment providers, and some HCBS providers. Those providers and their 5%+ owners must be fingerprinted within 30 days of a request. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

HCPF says site visits are required for all high-risk providers, including all non-emergent medical transportation providers, and that site visits are recorded. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Health First Colorado and CHP+ providers must revalidate at least every five years. HCPF emails providers about six months before their deadline and posts a revalidation-dates spreadsheet; claims are denied for providers that miss the date. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Colorado Medicaid enrollment guide →

CON program

No

Colorado certificate of need details →

Model

hybrid

State vendor

Sandata

Services in scope

• personal care
• home health

Alternate EVV allowed

Yes

Program

https://hcpf.colorado.gov/evv

Colorado EVV requirements →

State minimum wage

$15.16 an hour

Effective

2026-01-01

Scheduled increases

Rises to $15.71 in 2027 ($12.69 tipped), per the state labor department.

Direct-care wage floor

HCBS base wage: Medicaid HCBS providers must pay direct care workers at least $17.00/hour statewide in 2026 ($19.29 in Denver, $18.17 in Edgewater); if a local minimum wage is higher, the higher rate applies.

Rate pass-through

Providers attest annually to paying the base wage; non-compliance can lead to audits, corrective action, claim suspension or recoupment.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Home health agencies — active organization NPIs (NPPES)

1,490 (as of Sep 13, 2026)

Medicare-certified home health agencies (CMS Care Compare)

222 (as of May 27, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,188,599 (as of Jun 1, 2026)

All Colorado Home health Medicaid rates, ranked →