Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Do I need a license to run a non-medical home care agency in Missouri?
No state license, but Medicaid work needs a state contract.
Missouri licenses home health agencies that provide two or more home health services, such as nursing and home health aide visits, on a part-time or intermittent basis. DHSS's guide to the three types of care in the home says no license is issued for private-pay companies that provide only one service or care in shifts of 4 or more hours. To provide Medicaid in-home services (personal care, homemaker, chore, respite), you need an in-home services contract from MMAC instead, and the home health law does not apply to providers of in-home services under section 192.2000 (RSMo 197.460).
Written and checked September 22, 2026
How do I become a Medicaid in-home services (personal care) provider in Missouri?
Send a proposal to MMAC for a contract.
The provider must submit a written proposal to MMAC and be approved as a Title XX in-home services provider. It can then sign a Medicaid (Title XIX) participation agreement. Before approval, you designate a manager, and that manager must complete MMAC's certification course and then attend a yearly update meeting. MMAC's July 2026 training says you need a signed EVV vendor contract before an HCBS contract is awarded.
Written and checked September 22, 2026
What does a Missouri home health license cost, and how long does it last?
$600, renewed every year.
The law sets a $600 fee for an initial license, each annual renewal and a new license after a change of ownership. Renewal depends on a survey showing you meet the rules; the state rule adopts the Medicare Conditions of Participation. For a Medicare-certified agency, DHSS says the initial process also needs deemed status from a CMS-approved accrediting organization.
Written and checked September 22, 2026
Which EVV system do Missouri providers use?
Your own approved vendor, linked to the state's Sandata aggregator.
Provider agencies contract with an EVV vendor that the state has approved. The vendor must send visit data to the EVV Aggregator Solution (EAS), hosted by Sandata, at least once a day. You must log in to EAS at least once a week and tell MMAC within 30 days if you replace your EVV vendor.
Written and checked September 22, 2026
What happens if my claim doesn't match the EVV visit?
For personal care and A&D Waiver services, the claim is denied (from April 1, 2026, as scheduled).
Bulletin 48-45 set April 1, 2026 for denying claims for DSDS-authorized services (provider types 26 and 28) with no matching verified visit in EAS. You then correct the visit in your EVV system, resend it to EAS and resubmit the claim. Home health and developmental disabilities providers come in later phases; the latest bulletin we hold says their dates will be announced later.
Written and checked September 22, 2026
What training do in-home aides need in Missouri?
12 hours of orientation, then 5 hours a year.
In-home service workers need 12 hours of orientation within 30 days of hire, with at least 6 hours before their first day of participant contact. Orientation includes Alzheimer's and dementia training. After the first 12 months, 5 hours of in-service training a year are required; your agency may accept 2 hours of refresher training a year from a personal care aide employed 3 years who has completed 15 in-service hours.
Written and checked September 22, 2026
What background checks does Missouri require for home care workers?
Family Care Safety Registry, including the EDL and criminal history.
In-home services and home health providers must request Family Care Safety Registry (FCSR) screenings on all prospective employees; MMAC's training says this includes office staff. Personal care workers must also apply to register with the FCSR within 15 days of starting work (one-time fee $15). In-home providers must not employ anyone on the Employee Disqualification List (EDL). People barred by a criminal finding can apply to DHSS for a good cause waiver, but an EDL listing can't be waived.
Written and checked September 22, 2026
How do I report suspected abuse of an adult in Missouri?
Call 1-800-392-0210.
The DHSS Adult Abuse and Neglect Hotline takes calls 7 a.m. to 8 p.m., seven days a week, and reports can also be made online at health.mo.gov/abuse. In-home service providers must report all possible abuse, neglect or exploitation of a participant, including cases that may involve their own employee.
Written and checked September 22, 2026
Which Medicaid health plans pay for home care in Missouri?
The state's EVV specification lists three.
Home State Health, Healthy Blue and UnitedHealthcare are listed as payers for personal care and home health visits in the state's EVV vendor specification (July 2026). The EVV rule also covers these services when a managed care organization pays. Aged & Disabled Waiver homemaker, chore and respite visits are listed only under the state. We hold no MO HealthNet bulletin that lists the plans, so check with each plan about its coverage.
Written and checked September 22, 2026
What is Missouri's minimum wage?
$15.00 an hour in 2026.
The state's 2026 poster sets $15.00 an hour. Since August 28, 2025, the minimum wage has been based on HB 567 (2025). The $15.00 rate does not apply to retail and service businesses with annual gross sales under $500,000. Overtime is 1.5 times the regular rate for hours over 40 in a workweek.
Written and checked September 22, 2026