Compare states
Pick up to four states to see the basics side by side. Every cell comes from that state’s page, where each line links to the official document.
4 of 4 chosen. Tap a state to add or remove it.
| Topic | New York → | Pennsylvania → | California → | Texas → |
|---|---|---|---|---|
| License for non-medical home care | YesLHCSA license from the Department of Health for nursing, home health aide or personal care services · $2,000 application fee · annual registration. Homemaker and chore services are not named in the license requirement. | YesHome care agency or home care registry license from the Department of Health (28 Pa. Code Ch. 611) · $100 fee · a separate license for each physical location | YesHome Care Organization license from CDSS · renew every two years. Aides must be on the Home Care Aide Registry. | Yes, for personal careHCSSA license for personal assistance services (PAS) from HHSC · $2,625 for 3 years. Sitter-companion and chore services without personal care are exempt. |
| Home health and aide rules | New LHCSA or new county?LimitedPresumption of no need in 20 counties, including all of New York City, Nassau, Suffolk and Westchester. A county can be added to a license only where fewer than 5 LHCSAs actively serve patients. | License for home health?YesHome health care agency license (28 Pa. Code Ch. 601) · a regular license expires 1 year from issue. Medicaid home health also needs Medicare certification. | License for home health?YesHome health agencies are licensed by CDPH Licensing and Certification. Home health aides need a CDPH certificate. | License for home health?YesSame HCSSA license and fee, home health category (LHHS). Medicare-certified agencies are LCHHS. |
| EVV | RequiredMedicaid personal care since Jan. 1, 2021 and home health since Jan. 1, 2023. You choose your own system and send data to the state aggregator. | 85% rulePersonal assistance, respite (unlicensed settings) and home health visits. At least 85% of visits each quarter must have no manual edits; DHS flags providers over 15%. | In placeMedi-Cal personal care since Jan. 1, 2022 and home health since Jan. 1, 2023, through CalEVV or an approved alternate system | RequiredMedicaid personal attendant services (such as PCS, CFC and Primary Home Care) and, since Jan. 1, 2024, home health care services, in fee-for-service and health plans |
| Medicaid health plans | Yes: MLTC13 MLTC partial capitation plans on eMedNY's April 2026 list, plus Medicaid Advantage Plus and PACE plans | CHC plansPlans whose documents we hold: AmeriHealth Caritas PA CHC, Keystone First CHC, PA Health & Wellness, UPMC Community HealthChoices | Most of 25 plans, by countyPersonal Care and Homemaker Services is an optional Community Support each plan chooses county by county | STAR+PLUS, STAR KidsPlans pay personal care services (PCS) and Community First Choice (CFC) for their members, except CFC for STAR Kids members in the CLASS, DBMD, HCS or TxHmL waivers, which TMHP pays. |
| Act now |
| Nothing marked “act now” |
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| Next deadline | November 1, 2026Wage parity LS300 and LS301 due for calendar year 2025 | October 1, 2026PA Health & Wellness prior authorization changes | January 1, 2027Dementia care must be part of home care aides’ annual training | October 6, 2026HHSC begins surveying HCSSAs for SEMARC searches |
| Official documents | 178 documents | 180 documents | 145 documents | 78 documents |
Federal rules apply on top of every state. See the federal page →