How to Start A Home Health Agency in Mississippi (2026): License, Medicaid Enrollment & Rates

Licensing

Mississippi home health agency license

Mississippi requires a Home Health Agency license from Mississippi State Department of Health, Health Facilities Licensure and Certification to operate a home health agency. Fee: Initial and renewal applications carry a non-refundable fee set by the Board of Health; amount not printed in the standards.

License required: Yes
License: Home Health Agency license
Issuing agency: Mississippi State Department of Health, Health Facilities Licensure and Certification
Fee: Initial and renewal applications carry a non-refundable fee set by the Board of Health; amount not printed in the standards.
Renewal: Every year · Licenses expire June 30 and renew annually with the fee, an approved annual report for the prior calendar year, and evidence of CON where applicable.
Certificate of need: Required
Regulation: Miss. Code Ann. §§ 41-71-1 to 41-71-19 (licensure); § 41-7-191 et seq. (CON); MSDH Minimum Standards of Operation for Home Health Agencies (Chapter 46)

How to apply

Steps to get licensed in Mississippi

In order, as the licensing agency describes the process.

Obtain a Certificate of Need for the service area
Apply in writing on MSDH forms with ownership, service area, services, personnel and CON evidence
Receive a license listing the counties served (serving new counties requires a CON and a sub-unit)
Renew annually by June 30 with fee and annual report

Documents

What you need to submit

7 documents listed by the licensing agency.

Document
Ownership information
Geographic service area
Services provided directly or by arrangement

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Staffing

Staffing and training requirements

Staffing: Administrator: bachelor's degree plus one year of home health or related administrative experience within the last three years, or other listed qualifying experience
Full-time supervising nurse: Mississippi-licensed RN (BSN with one year RN experience, diploma with one year, or ADN with three years), with a designated alternate

Medicaid

Enrolling as a Mississippi Medicaid provider

Program: Mississippi Medicaid (Mississippi Division of Medicaid, DOM)
Enrollment portal: Medicaid Enterprise System Assistance (MESA) Provider Portal
Fiscal agent: Gainwell Technologies (DOM fiscal agent; sends recredentialing notices and does revalidation site visits)
Application fee: DOM charges institutional provider taxonomies on its list (e.g., home health, hospice, ASCs, ESRD, FQHCs, mental health centers, rehab facilities) $750 for 2026. The fee applies at initial enrollment, reactivation, revalidation or re-enrollment, ownership changes and new practice locations, and is paid by check to the Division of Medicaid (marked with the application tracking number) and mailed to Gainwell. Providers that already paid Medicare or another state are exempt. 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: Revalidating providers may have to submit fingerprints as part of screening. 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: Revalidating providers may need a site visit, done by Medicaid's fiscal agent. 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: DOM restarted revalidation on October 1, 2023, mailing notices to providers enrolled five years or more; revalidation is done in the MESA Provider Portal. DOM published a Medicaid Provider Revalidation Roadmap in August 2026. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Mississippi Medicaid enrollment guide →

Certificate of need

Does Mississippi require a certificate of need?

For this business: Required (licensing source)
CON program: Yes
Program: Certificate of Need
Agency: Mississippi State Department of Health, Office of Health Policy and Planning (Health Planning & Resource Development)
Services covered: nursing home care services (skilled nursing and ICF)
ICF/IID and nursing care for persons with developmental disabilities
pediatric skilled nursing facilities
acute psychiatric, chemical dependency and psychiatric residential treatment beds
obstetrical and neonatal special care services
comprehensive medical rehabilitation
ambulatory surgery
home health agencies / home health services
end stage renal disease facilities
general acute care hospitals and beds, swing beds, long-term care hospitals
MRI, PET, digital angiography, therapeutic radiation, stereotactic radiosurgery, cardiac catheterization, open-heart surgery
major medical equipment and capital expenditures above indexed thresholds; changes of ownership
Moratoria: Long-standing legislative moratoria (first imposed in 1990) bar new or expanded nursing home beds, ICF and ICF/IID beds, and new home health agencies. Effective April 17, 2026, the Legislature re-enacted and reaffirmed the nursing facility / ICF / ICF-IID moratorium (HB 1622, 2026 Regular Session, §2) and the home health agency moratorium.

Mississippi certificate of need details →

EVV

Electronic visit verification in Mississippi

Model: hybrid
State vendor: HHAeXchange (with FEI Systems)
Services in scope: personal care
in-home respite
home health
Alternate EVV allowed: Yes
Program: https://medicaid.ms.gov/mississippi-electronic-visit-verification-evv/

Mississippi EVV requirements →

Labor

Mississippi wage floor

State minimum wage: $7.25 an hour
Effective: 2009-07-24
Scheduled increases: No scheduled change found in the official sources reviewed.
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.

Market

Mississippi market size

Counts from federal public files: NPPES (active organization NPIs), CMS Care Compare and CMS Medicaid enrollment.

Home health agencies — active organization NPIs (NPPES): 558 (as of Sep 13, 2026)
Medicare-certified home health agencies (CMS Care Compare): 42 (as of May 27, 2026)
Total Medicaid and CHIP enrollment (latest reported month): 584,125 (as of Jun 1, 2026)

Rates

What Mississippi Medicaid pays

Home health: published Mississippi fee-for-service rates, each linked to its source.

Service	Mississippi rate	Per hour	Rank
Home health nurse visit (RN or LPN)Registered nurse	$151.47per visit	—	—
Home health aide visitAide or attendant	$75.48per visit	—	3 of 14
Home health physical therapyPhysical therapist	$65.00per visit	—	—
Home health speech therapySpeech-language pathologist	$65.00per visit	—	—

All Mississippi Home health Medicaid rates, ranked →

FAQ

Frequently asked questions

Do you need a license to start a home health agency in Mississippi?

Mississippi requires a Home Health Agency license from Mississippi State Department of Health, Health Facilities Licensure and Certification to operate a home health agency. Fee: Initial and renewal applications carry a non-refundable fee set by the Board of Health; amount not printed in the standards.

How much does a home health agency license cost in Mississippi?

Initial and renewal applications carry a non-refundable fee set by the Board of Health; amount not printed in the standards. Renewal: Every year · Licenses expire June 30 and renew annually with the fee, an approved annual report for the prior calendar year, and evidence of CON where applicable..

Does Mississippi require a certificate of need for a home health agency?

Yes, according to the licensing source. Mississippi's CON program covers: nursing home care services (skilled nursing and ICF), ICF/IID and nursing care for persons with developmental disabilities, pediatric skilled nursing facilities, acute psychiatric, chemical dependency and psychiatric residential treatment beds, obstetrical and neonatal special care services, comprehensive medical rehabilitation, ambulatory surgery, home health agencies / home health services, end stage renal disease facilities, general acute care hospitals and beds, swing beds, long-term care hospitals, MRI, PET, digital angiography, therapeutic radiation, stereotactic radiosurgery, cardiac catheterization, open-heart surgery, major medical equipment and capital expenditures above indexed thresholds; changes of ownership.

How do you become a Medicaid provider in Mississippi?

Enroll through Medicaid Enterprise System Assistance (MESA) Provider Portal (https://portal.ms-medicaid-mesa.com/), run by Gainwell Technologies (DOM fiscal agent; sends recredentialing notices and does revalidation site visits).

What does Mississippi Medicaid pay a home health agency?

Mississippi Medicaid pays $151.47 per visit for home health nurse visit (rn or lpn), effective Oct 1, 2025.

How to start a home health agency in Mississippi