How to start a home health agency in Tennessee
Tennessee requires a Home care organization license — home health services from Tennessee Health Facilities Commission to operate a home health agency. Fee: $1,404.
- License required
- YesHome care organization license — home health services
- Application fee
- $1,404
- Processing time
- —
- Medicaid rate
- —
- Organizations in the state
- 960NPPES, Sep 13, 2026
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Tennessee home health agency license
Tennessee requires a Home care organization license — home health services from Tennessee Health Facilities Commission to operate a home health agency. Fee: $1,404.
- License required
- Yes
- License
- Home care organization license — home health services
- Issuing agency
- Tennessee Health Facilities Commission
- Fee
- $1,404
- Fee details
- $1,404 annual license fee submitted with the application; nonrefundable.
- Renewal
- Every year · Licenses expire each year on the anniversary of issuance. Late renewal within 60 days costs an extra $100 per month; after 60 days the agency must reapply.
- Survey and inspection
- Licensees are subject to periodic inspections; deficiencies require an accepted plan of correction.
- Certificate of need
- Required
- Medicare certification
- The HFC alerts new home health CON applicants to the CMS enrollment moratorium. Separately, CMS put a 6-month nationwide moratorium on new Medicare enrollment of home health agencies (including new branches and practice locations) into effect on May 13, 2026; it can be extended in 6-month increments, and CMS left any Medicaid/CHIP moratorium to each state.
- Regulation
- T.C.A. § 68-11-201 et seq.; T.C.A. § 68-11-1601 et seq. (CON); Tenn. Comp. R. & Regs. 0720-27
Steps to get licensed in Tennessee
In order, as the licensing agency describes the process.
- Obtain a Certificate of Need for establishing a home care organization and starting home health services in the proposed counties
- Apply for the license on the state form with the $1,404 fee
- Inspection; submit an acceptable plan of correction if deficiencies are cited
- Licensed for the counties set by the CON; no patients before the license is issued
Enrolling as a Tennessee Medicaid provider
- Program
- TennCare (Division of TennCare, Tennessee)
- Enrollment portal
- TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers
- Application fee
- Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. TennCare's registration pages do not list a separate state fee.
- Fingerprinting
- Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. TennCare's registration pages do not describe a separate state fingerprint process.
- Site visit
- Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. TennCare's registration pages do not describe a separate state site visit process.
- Revalidation
- Every TennCare provider enrollment must be revalidated every 3 years, more often than the federal 5-year minimum. Submitting any update in the enrollment portal resets the due date. Groups and entities see the due date at the top of their enrollment. Individual providers revalidate by submitting their Data Spring (CAQH ProView) application.
Does Tennessee require a certificate of need?
- For this business
- Required (licensing source)
- CON program
- Yes
- Program
- Certificate of Need
- Services covered
- hospitals
- nursing homes (and nursing home bed increases beyond the lesser of 10 beds or 10% once every 3 years)
- ambulatory surgical treatment centers
- home care organizations (home health and hospice)
- residential hospice
- outpatient diagnostic centers
- rehabilitation facilities
- nonresidential substitution-based opiate treatment centers
- open heart surgery, organ transplantation, cardiac catheterization, linear accelerators
- MRI/PET initiation in counties of 175,000 or fewer; pediatric MRI in larger counties
- bed redistribution/relocation, facility relocation, hospital satellite EDs and satellite inpatient facilities
Electronic visit verification in Tennessee
- Model
- MCO-chosen
- State vendor
- Sandata (BlueCare); CareBridge (Wellpoint, UnitedHealthcare); Therap (DDA waiver services)
- Services in scope
- personal care (CHOICES, ECF CHOICES)
- attendant care
- 1915(c) waiver services
- private duty nursing
- home health
- Alternate EVV allowed
- Yes
Tennessee 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.
Tennessee 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)
- 960 (as of Sep 13, 2026)
- Medicare-certified home health agencies (CMS Care Compare)
- 128 (as of May 27, 2026)
- Total Medicaid and CHIP enrollment (latest reported month)
- 1,384,007 (as of Jun 1, 2026)
What Tennessee Medicaid pays
Home health: published Tennessee fee-for-service rates, each linked to its source.
Frequently asked questions
Do you need a license to start a home health agency in Tennessee?
Tennessee requires a Home care organization license — home health services from Tennessee Health Facilities Commission to operate a home health agency. Fee: $1,404.
How much does a home health agency license cost in Tennessee?
$1,404 Renewal: Every year · Licenses expire each year on the anniversary of issuance. Late renewal within 60 days costs an extra $100 per month; after 60 days the agency must reapply..
Does Tennessee require a certificate of need for a home health agency?
Yes, according to the licensing source. Tennessee's CON program covers: hospitals, nursing homes (and nursing home bed increases beyond the lesser of 10 beds or 10% once every 3 years), ambulatory surgical treatment centers, home care organizations (home health and hospice), residential hospice, outpatient diagnostic centers, rehabilitation facilities, nonresidential substitution-based opiate treatment centers, open heart surgery, organ transplantation, cardiac catheterization, linear accelerators, MRI/PET initiation in counties of 175,000 or fewer; pediatric MRI in larger counties, bed redistribution/relocation, facility relocation, hospital satellite EDs and satellite inpatient facilities.
How do you become a Medicaid provider in Tennessee?
Enroll through TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers (https://www.tn.gov/tenncare/providers/provider-registration/how-to-apply.html).