HomeCareAtlas Team · Updated November 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in Massachusetts
Starting a home care agency in Massachusetts costs roughly $55,000 - $100,000 (our estimate) and takes 4-8 Weeks. Here's every step, fee, and deadline — sourced directly from Executive Office of Health and Human Services (EOHHS) — new home care agency licensing under Chapter 180 of the Acts of 2026, with the Executive Office of Aging & Independence and DPH.
Right now, Massachusetts has no license for private-pay, non-medical home care. The Department of Public Health (DPH) licenses home health agencies. Those give skilled nursing or therapy. State-funded home care runs through the Executive Office of Aging & Independence and local ASAPs. That is changing. On August 6, 2026, the governor signed H.5627, "An Act to Improve Massachusetts Home Care." It is Chapter 180 of the Acts of 2026. It creates the first state license for home care agencies. EOHHS must write the rules within one year of the law starting. You must be licensed by a date EOHHS sets, no later than one year after the rules. Until then, you can open with a business registration and insurance.
Massachusetts does not require a state license to operate a non-medical home care agency. You can begin operations after completing standard business formation (LLC, EIN, business license) and obtaining insurance. Total startup costs range from $55,000 - $100,000 (our estimate), and you can be operational within 4-8 weeks. No state license is required today, but Chapter 180 of the Acts of 2026 (signed August 6, 2026) creates a home care agency license. Rules are due about November 2027. Start background checks on every worker now — the new law will require them.
- License Required
- No — Business license only
- Regulatory Body
- Executive Office of Health and Human Services (EOHHS) — new home care agency licensing under Chapter 180 of the Acts of 2026, with the Executive Office of Aging & Independence and DPH
- Application Fee
- $0 (no state license fee)
- Timeline
- 4-8 Weeks (business setup estimate (license rules due 2027))
- Total Startup Cost
- $55,000 - $100,000 (our estimate)
- Key Requirement
- No state license is required today, but Chapter 180 of the Acts of 2026 (signed August 6, 2026) creates a home care agency license. Rules are due about November 2027. Start background checks on every worker now — the new law will require them.
- Last Verified
- November 2026 against Executive Office of Health and Human Services (EOHHS) — new home care agency licensing under Chapter 180 of the Acts of 2026, with the Executive Office of Aging & Independence and DPH regulations
No License Fee Yet (Rules Pending)
Source: M.G.L. c. 6A, §16II(b)(3) · Checked Oct 2026 · A change is coming
Business Setup Estimate (License Rules Due 2027)
This is our best guess. Check with the Executive Office of Health and Human Services (EOHHS) — new home care agency licensing under Chapter 180 of the Acts of 2026, with the Executive Office of Aging & Independence and DPH.
Residents Age 70+
Moderate Opportunity
How Massachusetts compares to neighboring states
| State | License Fee | Timeline | Startup Cost |
|---|---|---|---|
| Massachusetts ← | $0 (no license) | 4-8 Weeks | $55,000 - $100,000 (our estimate) |
| Connecticut | $375 | 1-3 Months | $35,000 - $70,000 |
| New York | $2,000 | 9-18 Months | $100,000 - $200,000 |
| Rhode Island | $650 | 2-4 Months | $45,000 - $80,000 |
| New Hampshire | $250 | 30-90 Days | $35,000 - $70,000 |
Massachusetts Licensing Overview
The Executive Office of Health and Human Services (EOHHS) — new home care agency licensing under Chapter 180 of the Acts of 2026, with the Executive Office of Aging & Independence and DPH oversees all non-medical agencies.Right now, Massachusetts has no license for private-pay, non-medical home care. The Department of Public Health (DPH) licenses home health agencies. Those give skilled nursing or therapy. State-funded home care runs through the Executive Office of Aging & Independence and local ASAPs. That is changing. On August 6, 2026, the governor signed H.5627, "An Act to Improve Massachusetts Home Care." It is Chapter 180 of the Acts of 2026. It creates the first state license for home care agencies. EOHHS must write the rules within one year of the law starting. You must be licensed by a date EOHHS sets, no later than one year after the rules. Until then, you can open with a business registration and insurance.
No State License Yet
Today you need a business registration with the Secretary of the Commonwealth, an EIN, and workers' comp. No home care license exists yet. Do not let anyone sell you one.
Run Background Checks on Every Worker
Check every worker before they meet a client. Most agencies use the state CORI system. We found no law that makes private-pay agencies do this today. The new law will require it once its rules start. It also adds checks in any state where a worker lived or worked in the last 5 years.
New License Law (Chapter 180, Acts of 2026)
Signed August 6, 2026. EOHHS will license home care agencies. Rules are due about November 2027. That assumes the usual 90-day start date plus the law's 1-year rule deadline. Licenses will be required within one year after that. Once the rules start, EOHHS can fine up to $500 per day for breaking them.
Estimated Startup Costs (2026)
Budget for $55,000 - $100,000 (our estimate) to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| Business Formation (LLC with Secretary of the Commonwealth) | $500 | $800 |
| General Liability Insurance (often $1M/$3M) | $2,500 | $6,000 |
| Professional Liability Insurance | $800 | $2,500 |
| Workers' Compensation Insurance | $1,500 | $4,500 |
| Bond (only if a contract asks) | $0 | $800 |
| Background Checks (initial staff) | $400 | $1,200 |
| Office Setup | $1,200 | $4,500 |
| Scheduling & Care Management Software | $800 | $2,500 |
| Initial Marketing & Website | $2,500 | $7,000 |
| Working Capital (3-6 months) | $22,000 | $55,000 |
We map every cost and file your Massachusetts license for you.
How to Start a Home Care Agency in Massachusetts
1-2 Weeks
Form Your Business
Register your LLC or corporation with the Massachusetts Secretary of the Commonwealth. Get an EIN from the IRS. Register with the Department of Revenue to withhold state taxes.
1-2 Weeks
Get Insurance
Workers' comp is required by state law once you have employees. General and professional liability are not required today, but clients and partners expect them. The new license rules will set minimum insurance amounts.
1-2 Weeks
Set Up Background Checks
Register for iCORI, the state's online criminal record system. Check every worker before they meet a client. The new law will make background checks a must once its rules start.
2-3 Weeks
Write Your Policies
Write simple rules for client care, hiring, safety, emergencies, privacy, and complaints. The new law lists topics the rules will cover. Use that list as a guide now.
1-3 Weeks
Set Up Your Office
Rent an office or use a home office if your town's zoning allows it. Set up scheduling and care management software.
2-4 Weeks
Hire and Train Caregivers
Hire home care aides or personal care workers. Check each one before they start. Train them on your rules, client care, and safety.
2-4 Weeks
Build Your Referral Network
Make a simple website. Set up a Google Business Profile. Meet hospitals, rehab centers, elder care groups, and doctors. Most new agencies start with private-pay clients.
4-8 Weeks (if pursuing)
Think About MassHealth and the New Rules
To serve MassHealth clients, enroll as a provider. Watch EOHHS for the new license rules. They are due about November 2027. That date assumes the law took effect the usual 90 days after signing, plus its 1-year rule deadline.
We can do all of them for you in Massachusetts.
New 2026 Legal Mandates
Home Care Agency License Law (Chapter 180 of the Acts of 2026)
Signed August 6, 2026; rules due about November 2027 - The governor signed H.5627, "An Act to Improve Massachusetts Home Care," on August 6, 2026. It is Chapter 180 of the Acts of 2026. Once licenses are required, no one may run or advertise a home care agency without one. The license will last 3 years. EOHHS must adopt rules within one year of the law starting. Licenses become required no later than one year after that. Agencies that already contract with an ASAP or MassHealth can get a temporary license. Those rules are due within 180 days. Home health agencies, hospices, ASAPs, federal or state government agencies, and house cleaning services are exempt. The rules must include background checks, training, workers' comp, and liability insurance. Up to $500 per day for not following the law or its rules
Background Checks Are Coming as a Must
Once the rules start, every home care worker will need checks. These include a Massachusetts criminal check and checks in other states where they lived or worked in the last 5 years. You must also check the federal OIG exclusion list and the nurse aide registry. Workers who drive clients need a driving record check. Start now so you are ready.
Training Topics in the New Law
The rules must require training on client privacy, infection control, emergencies and falls, reporting changes, spotting abuse, dementia care, and wage law rights. The law does not set hours. EOHHS will.
Workers' Compensation Required
Massachusetts requires workers' comp for your employees (M.G.L. c. 152). Without it, the state can stop your business and fine you.
Wage and Leave Laws
Follow federal wage rules (FLSA), I-9 checks, and IRS payroll rules. Massachusetts also has earned sick time and Paid Family and Medical Leave.
Executive Office of Aging & Independence
The Executive Office of Aging & Independence used to be called Elder Affairs. It runs the state Home Care Program through local ASAPs (Aging Services Access Points). State-funded home care clients come through ASAP contracts.
No State Bond Today
Massachusetts does not require a bond today. The new law does not ask for one either. It does call for workers' comp and liability insurance. EOHHS rules could still add more. Some contracts may ask for a bond.
Our Massachusetts licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
Massachusetts is a high-wage state for caregivers. Price your services with that in mind. Check every caregiver before they start. The new law will require it.
- Criminal Background Check: Run a criminal record check (CORI) before a worker meets clients. The new license law will require background checks once its rules start.
- DPPC Abuser Registry (DDS Providers Only): The Disabled Persons Protection Commission keeps an abuser registry. Employers that serve people through the Department of Developmental Services (DDS) must check it (M.G.L. c. 19C, §15). Pure private-pay elder care is not covered.
- Training Records: Keep a record of each caregiver's orientation, training, and skills checks. The new rules will require yearly and ongoing training.
- Aide Skills: No state certificate is required for non-medical aides today. Hire caring people and check their skills before they work alone.
- Orientation: Teach your rules, client rights, safety, emergencies, infection control, and privacy.
- Ongoing Training: Hold regular training. The new law will require training on privacy, infection control, dementia care, and wage law once the rules are final.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch Massachusetts home care agencies start to finish.
Regional Market Opportunities
Massachusetts has about 7.2 million people. About 1.42 million are 65 or older (19.9%, Census 2025 estimate). Many families can pay privately. Boston and its suburbs are the biggest market. Western Massachusetts and Cape Cod have many seniors and less competition. Note: the billing rates below are our estimates, not official numbers.
Greater Boston (Suffolk, Middlesex, Norfolk Counties)
The biggest market, with many large hospitals. High-income suburbs have strong private-pay demand. It is also the most crowded market.
Key: Do not underprice in high-income towns. Get to know your local ASAP and hospital discharge planners.
Worcester / Central Massachusetts
The second-largest city, with a big medical center. Costs are lower than Boston.
Key: A good mix of demand and competition.
Springfield / Western Massachusetts
Lower costs and less competition. Rural hill towns have few home care choices.
Key: Startup costs are lower here. Rural towns need more help.
Cape Cod / Islands
Many seniors live here. Demand often jumps in summer when families visit.
Key: Housing costs make hiring hard. Think about paying for travel time.
South Shore / Plymouth County
Growing suburbs with many seniors who want to stay home.
Key: Less crowded than Boston, with strong suburban demand.
Cost of care in Massachusetts
What agencies charge clients vs. what caregivers earn in Massachusetts. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$37.5
Avg. hourly rate charged to clients
$23.35
Avg. caregiver hourly wage
$14.15
Gross margin per hour
38%
Gross margin %
What this means for agency owners
In Massachusetts, agencies keep roughly $14.15 per billable hour after paying the caregiver. That's a 38% gross margin.
This is a typical margin for the industry. You will need to manage overhead carefully, but profitability is achievable with good operations.
Sources: Avg. hourly rate from CareYaya and CareScout 2025 surveys (averaged). Caregiver wage from Care.com. Gross margin is before overhead costs like insurance, admin, marketing, and compliance.
Massachusetts Medicaid Programs
MassHealth HCBS Waivers (Frail Elder Waiver)
MassHealth pays for some home care through waivers, like the Frail Elder Waiver. These help seniors stay at home instead of a nursing home.
MassHealth Provider Enrollment
To serve MassHealth clients, you must enroll as a provider. That has its own rules. Many agencies start with private pay and add MassHealth later.
ASAP Network (Aging Services Access Points)
ASAPs run state-funded elder home care in each area. They contract with home care agencies. A good link with your local ASAP can bring steady clients. ASAP contracts also qualify you for a temporary license under the new law.
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
Massachusetts Licensing FAQ
Do I need a license to start a home care agency in Massachusetts?
Not yet. Massachusetts has no license for non-medical home care today. You need a business registration, an EIN, workers' comp, and to follow job laws. But a new law (Chapter 180 of the Acts of 2026) creates a home care agency license. EOHHS must write the rules by about November 2027. You will need a license within one year after that.
How much does it cost to start a home care agency in Massachusetts?
We estimate $55,000 to $100,000. Massachusetts costs more than many states. Insurance, wages, and rent are high. Most of the money is working capital to pay staff before clients pay you.
How long does it take to start in Massachusetts?
No license is required yet. We estimate 4-8 weeks to open. That covers forming your business, insurance, background check setup, and hiring. MassHealth enrollment adds more time. Plan for the new license rules due in 2027.
What are CORI checks and are they required?
CORI is Massachusetts' criminal record system. You run checks through iCORI online. We found no law that makes private-pay agencies run checks today. The new license law (Chapter 180) will require background checks once its rules start. Do them now anyway.
Can I operate from a home office in Massachusetts?
Often yes. No state home care rule bans it today. Check your town's zoning rules first. The new license rules could add office rules, so watch for them.
Is Massachusetts a good market for home care?
Yes. Massachusetts has about 1.42 million adults 65 and older (Census 2025 estimate). Many families can pay privately. We estimate rates of $30-$50/hr, based on the area. No license is needed yet. The main challenge is high caregiver wages. You need to price high enough to cover them.
Will Massachusetts require a license in the future?
Yes. The governor signed H.5627 (Chapter 180 of the Acts of 2026) on August 6, 2026. It creates the first state license for home care agencies. EOHHS must adopt rules within one year of the law starting. All agencies must be licensed no later than one year after that. Starting now lets you grow before the rules start.
What is the ASAP network and why does it matter?
ASAPs (Aging Services Access Points) run state-funded elder home care in each part of the state. They hire home care agencies to serve their clients. A contract with your local ASAP can bring steady work. Under the new law, it also lets you get a temporary license early.
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
Connecticut
$375 fee · 1-3 Months
New York
$2,000 fee · 9-18 Months
Rhode Island
$650 fee · 2-4 Months
New Hampshire
$250 fee · 30-90 Days
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Sizing up the competition? See the 1,000 home care agencies already operating in Massachusetts →
Home care agencies in Massachusetts
Want to see the competition up close? Look at who is already open, city by city.
- Home care agencies in Worcester
- Home care agencies in South Chelmsford
- Home care agencies in Brockton
- Home care agencies in Boston
- Home care agencies in Amostown
Looking for care for a family member? Find agencies near you
Considering other states?
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Where our numbers come from
We check each fact against Massachusetts's own rules. Tap a source to read it yourself.
- License needed?NoSt. 2026, c. 180, §7· Oct 2026
- Who oversees itExecutive Office of Health and Human Services (EOHHS) — new home care agency licensing under Chapter 180 of the Acts of 2026, with the Executive Office of Aging & Independence and DPHM.G.L. c. 6A, §16HH (St. 2026, c. 180, §1)· Oct 2026
- License name—M.G.L. c. 6A, §16II(b)(1)· Oct 2026
- The rulesSt. 2026, c. 180 (M.G.L. c. 6A, §§16HH-16KK); EOHHS rules pendingSt. 2026, c. 180, §1· Oct 2026
- First license feeno feeM.G.L. c. 6A, §16II(b)(3)· Oct 2026
- License lasts—M.G.L. c. 6A, §16II(b)(1)· Oct 2026
- BondNone (no state bond today; Chapter 180 does not require one, but EOHHS rules are still pending)M.G.L. c. 6A, §16II(e)(3)(iii)· Oct 2026
- Owner/manager trainingNo state minimumM.G.L. c. 6A, §16II(e)(3)· Oct 2026
- Caregiver trainingNo state minimumM.G.L. c. 6A, §16II(e)(3)(v)· Oct 2026
- Background checksUnder Chapter 180 rules: Massachusetts CORI, out-of-state checks for anywhere the worker lived or worked in the last 5 years, the federal OIG exclusion list, and the nurse aide registryM.G.L. c. 6A, §16II(e)(3)(i)· Oct 2026
- How long it takes4-8 WeeksBest guess — not confirmed yet
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This guide is for informational purposes only and does not constitute legal, regulatory, or business advice. Licensing requirements, fees, and regulations change frequently. Always verify current requirements with your state's licensing agency before making business decisions. HomeCareAtlas is not responsible for the accuracy or completeness of this information.
Researched and reviewed by
John Helmy, Founder of HomeCareAtlasBuilding tools and resources to help home care agency owners navigate licensing, compliance, and growth.