50-State Regulatory Atlas Data and maps Certificate of need: home health
Licensing · Map layer
States that require a certificate of need for home health (2026)
14 jurisdictions require a certificate of need for home health (14 verified, 0 provisional) and 3 require one only for Medicare or Medicaid agencies; 7 are not confirmed.
Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.
- Required 14
- Only for Medicare or Medicaid agencies 3
- Not required 27
- Not confirmed 7
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Every state
| State | Answer | Value | Verification | Industry list (2026) |
|---|---|---|---|---|
| Alabama | Yes | Yes. | Verified | On the 2026 Alliance list |
| Alaska | No | No. | Verified | Not on the 2026 Alliance list |
| Arizona | No | No. | Verified | Not on the 2026 Alliance list |
| Arkansas | Yes | Yes, as a Permit of Approval for the geographic area, obtained before a license is issued. | Verified | On the 2026 Alliance list |
| California | No | No. | Verified | Not on the 2026 Alliance list |
| Colorado | No | No. | Verified | Not on the 2026 Alliance list |
| Connecticut | Unresolved | Sources conflict. | Disputed | On the 2026 Alliance list |
| Delaware | Unresolved | Not confirmed. | Provisional | Not on the 2026 Alliance list |
| District of Columbia | Yes | Yes. | Verified | On the 2026 Alliance list |
| Florida | No | No. | Verified | Not on the 2026 Alliance list |
| Georgia | Yes | Yes, before a new agency opens and before an existing agency expands its geographic service area. | Verified | On the 2026 Alliance list |
| Hawaii | Conditional | Yes for an agency seeking federal certification; otherwise SHPDA issues a letter saying no certificate of need is needed. | Verified | On the 2026 Alliance list |
| Idaho | No | No. | Verified | Not on the 2026 Alliance list |
| Illinois | No | No. | Verified | Not on the 2026 Alliance list |
| Indiana | No | No. | Verified | Not on the 2026 Alliance list |
| Iowa | No | No. | Verified | Not on the 2026 Alliance list |
| Kansas | No | No. | Verified | Not on the 2026 Alliance list |
| Kentucky | Yes | Yes. | Verified | On the 2026 Alliance list |
| Louisiana | Unresolved | Whether facility need review applies to home health: | Provisional | Not on the 2026 Alliance list |
| Maine | Unresolved | Whether Maine’s certificate of need reaches home health agencies: | Provisional | Not on the 2026 Alliance list |
| Maryland | Yes | Yes. | Verified | Not on the 2026 Alliance list |
| Massachusetts | No | No. | Verified | Not on the 2026 Alliance list |
| Michigan | No | No. | Verified | Not on the 2026 Alliance list |
| Minnesota | No | No. | Verified | Not on the 2026 Alliance list |
| Mississippi | Yes | Yes. | Verified | On the 2026 Alliance list |
| Missouri | No | No. | Verified | Not on the 2026 Alliance list |
| Montana | No | No, since October 1, 2021. | Verified | Not on the 2026 Alliance list |
| Nebraska | No | No. | Verified | Not on the 2026 Alliance list |
| Nevada | Unresolved | Unclear. | Provisional | Not on the 2026 Alliance list |
| New Hampshire | Unresolved | Provisional | Not on the 2026 Alliance list | |
| New Jersey | Yes | Yes, before home health agency licensure. | Verified | On the 2026 Alliance list |
| New Mexico | No | No. | Verified | Not on the 2026 Alliance list |
| New York | Yes | Yes, as public-need review. | Verified | On the 2026 Alliance list |
| North Carolina | Conditional | Medicare-certified home health agencies only. | Verified | On the 2026 Alliance list |
| North Dakota | No | No. | Verified | Not on the 2026 Alliance list |
| Ohio | No | No. | Verified | Not on the 2026 Alliance list |
| Oklahoma | No | No. | Verified | Not on the 2026 Alliance list |
| Oregon | No | No. | Verified | Not on the 2026 Alliance list |
| Pennsylvania | Unresolved | Not found. | Provisional | Not on the 2026 Alliance list |
| Rhode Island | Yes | Yes, for both licenses, before establishment and initial licensure. | Verified | On the 2026 Alliance list |
| South Carolina | Yes | Yes. | Verified | On the 2026 Alliance list |
| South Dakota | No | No. | Verified | Not on the 2026 Alliance list |
| Tennessee | Yes | Yes. | Verified | On the 2026 Alliance list |
| Texas | No | No. | Verified | Not on the 2026 Alliance list |
| Utah | No | No. | Verified | Not on the 2026 Alliance list |
| Vermont | Yes | Yes, for “the offering of any home health service”, with no dollar threshold. | Verified | Not on the 2026 Alliance list |
| Virginia | No | No. | Verified | Not on the 2026 Alliance list |
| Washington | Conditional | Medicare and Medicaid agencies only, per county: serving a new county counts as a new agency. | Verified | On the 2026 Alliance list |
| West Virginia | Yes | Yes, including any expansion of a home health agency’s service area (W. | Verified | On the 2026 Alliance list |
| Wisconsin | No | No. | Verified | Not on the 2026 Alliance list |
| Wyoming | No | No. | Verified | Not on the 2026 Alliance list |