50-State Regulatory Atlas Missouri
State licensing summary
Missouri: healthcare licensing and regulation
Missouri: state license; branch rule not confirmed; no certificate of need; compact member. Regulator: Missouri Department of Health and Senior Services.
Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.
10 findings: 8 verified, 2 provisional. How findings are sourced and labelled.
At a glance
- License
- State license requiredVerified
- Regulator
- Missouri Department of Health and Senior Services
- Branch offices
- State license; branch rule not confirmedProvisional
- Certificate of need
- No certificate of needVerified
- Service area
- An out-of-state agency’s Missouri area must be contiguous to the area it serves at home.Verified
- In-state office
- See out-of-state rules below
- Medicare certification
- Separate federal step, only for agencies that bill MedicareVerified
Home health licensing
State license
VerifiedYes. The Department of Health and Senior Services licenses home health agencies (RSMo 197.400–.477; 19 CSR 30-26.010, which adopts the Medicare Conditions of Participation). An agency must offer two skilled services, one of them nursing. Licenses renew annually.
In practice: Hold the authority the state requires before the first patient is admitted there, and keep its number, category and expiry with the office it covers.
Source: 19 CSR 30-26.010
Branch offices
ProvisionalThe rule has no branch provision. Confirm with the state agency
In practice: Track each office’s authority on its own where the state licenses offices separately, and with the parent where it lists them.
Service area
VerifiedAn out-of-state agency’s Missouri area must be contiguous to the area it serves at home.
In practice: Check the patient’s address against the approved service area before accepting a referral.
Out-of-state agencies
VerifiedAn out-of-state applicant must be a Medicare-certified home health agency of a bordering state with a reciprocal agreement with Missouri, and must establish a Missouri business location.
In practice: A license in one state does not authorize care in another; the patient’s state decides.
Home infusion nursing
Home infusion nursing
ProvisionalBecause two skilled services are required, whether a nursing-only agency qualifies: Confirm with the state agency
In practice: Confirm the license category before staffing infusion visits in this state.
Staffing and nurse licensure
Nurse licensure (compact)
VerifiedMember of the Nurse Licensure Compact, implemented. A nurse with a multistate license from another compact state may practice here; the agency still needs this state’s own authority to operate.
In practice: Check each nurse’s license against the patient’s state, not the agency’s.
Detailed state rules for staffing agencies in this state are being added.
Medicare, hospice and VA programs in this state
Missouri is not one of the six states in CMS’s Review Choice Demonstration for home health (Illinois, Ohio, Texas, North Carolina, Florida, Oklahoma).
Source: CMS: Review Choice Demonstration for Home Health Services
Missouri is not one of the six states (Arizona, California, Nevada, Texas, Georgia, Ohio) where CMS applies its provisional period of enhanced oversight to newly enrolling hospices.
Source: CMS Medical Review: Hospice
VA Community Care Network region
VerifiedMissouri is in Community Care Network Region 2, administered by Optum. Agencies join by contracting with the regional third-party administrator, not with VA. VA has re-procured the network as CCN Next Generation with two regions, East and West; which administrator serves which region from 2027 was not announced in the sources reviewed.
Time-sensitive. Region assignments change with CCN Next Generation; recheck VA’s announcements during 2027.
Source: VA: Community Care Network
Federal rules that apply in every state
Medicare certification
VerifiedMedicare certification under the home health Conditions of Participation (42 CFR Part 484) is a federal step for agencies that bill Medicare home health. It is separate from the state license. Where a state ties entry to certification, that state’s findings say so.
In practice: A branch serving a portion of the parent’s area is supervised and administered by the parent agency (42 CFR 484.2).
Source: 42 CFR 484.2
For a Medicare-certified agency, “its personnel must be qualified in all States in which they provide services” (State Operations Manual § 2184).
In practice: Nurse licensure follows the patient’s state.
Medicare’s home infusion therapy benefit is a separate Part B supplier benefit, not a home health benefit. It pays an accredited, qualified home infusion therapy supplier for professional services tied to specific parenteral drugs given through a pump that is durable medical equipment (42 CFR Part 486, Subpart I).
In practice: Most pharmacy-dispensed home infusion is not billable under this benefit; nursing for those patients is usually paid by other payers or under contract.
Compared with Texas
Annual term, renewal tied to state survey, and a bordering-state path for certified agencies.
Other service lines
State rules for these lines are being added to the guide: Medicare home health, Medicare home infusion therapy benefit, Infusion pharmacy, Hospice, Private duty nursing, Personal care and Medicaid HCBS, VA community care, Infusion suites.
Look up a licensed provider
- DHSS Home Care provider directory VerifiedMissouri Department of Health and Senior Services, Bureau of Home Care & Rehabilitative Standards
All home health and hospice providers the bureau licenses or certifies, with open-data versions on data.mo.gov including license number and expiry.
National lookups
- Medicare Care Compare — Home health
Medicare-certified home health agencies with quality ratings and services offered.
- Medicare Care Compare — Hospice
Medicare-certified hospices with quality measures.
- CMS Provider Data Catalog — Home Health Care Agencies (6jpm-sxkc)
All Medicare-registered home health agencies with CCN, address, ownership, services, certification date and quality measures, as CSV and an unauthenticated API.
- CMS Provider Data Catalog — Hospice – General Information (yc9t-dgbk)
Medicare-certified hospices with CCN, address, county, ownership type and certification date, as CSV and an unauthenticated API.
- CMS QCOR — HHA 2567 Statements of Deficiencies
Federal survey statements of deficiencies for home health agencies, filterable by state, survey type, tag and CCN, with a full-dataset XLSX download.
- CMS QCOR — Hospice 2567s
Federal survey statements of deficiencies for hospices.
- NPPES NPI Registry
National Provider Identifier records with addresses, authorized official and taxonomies, with a public API.
- HHS-OIG List of Excluded Individuals/Entities (LEIE)
Individuals and entities excluded from federal health care programs, with a monthly downloadable database.
- SAM.gov Exclusions
Federal exclusion records across agencies.
- Nursys QuickConfirm
Nurse license status, discipline / board-issued alerts and expiry, free to employers and the public.
Associations
- Missouri Alliance for Care at Home (MACH)home health, hospice
Supports and advocates for the home care industry with education and events, hospice programming, membership, and falls and infection benchmarking projects.
- Missouri Hospice & Palliative Care Association (MHPCA)hospice, palliative care
Supports coordinated care for terminally ill Missourians.
Official sources
About this guide. Published and maintained by Paloma Health Technologies; Findings are cited to official sources, dated and status-labelled; see the editorial policy. Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.