HomeCareAtlas Team · Updated September 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in Montana
Starting a home care agency in Montana costs roughly $33,500 - $94,000 and takes 1-3 months. Here's every step, fee, and deadline — sourced directly from No state license for non-medical care. Montana DPHHS licenses home health agencies and enrolls Medicaid providers..
Montana is one of a handful of states that does not require a specific state license to run a non-medical home care agency. You can start providing personal care, companionship, and homemaker services without a state-level home care license. You still need to form a legal business entity, get insurance, and follow all federal and state business rules. Skilled home health is different. That means nursing or therapy at home. Montana law says a home health agency must offer a registered nurse (MCA 50-5-101). It needs a DPHHS license. DPHHS gives a 6-month provisional license first. Then a surveyor visits you. Medicare certification is a separate step.
Montana 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 $33,500 - $94,000, and you can be operational within 1-3 months. No state license for non-medical care and no Certificate of Need. Register your business and get workers' comp to start. Medicaid PAS agencies must train attendants 16 hours up front.
- License Required
- No — Business license only
- Regulatory Body
- No state license for non-medical care. Montana DPHHS licenses home health agencies and enrolls Medicaid providers.
- Application Fee
- $0 (no state license fee)
- Timeline
- 1-3 months (typical timeline (estimate))
- Total Startup Cost
- $33,500 - $94,000
- Key Requirement
- No state license for non-medical care and no Certificate of Need. Register your business and get workers' comp to start. Medicaid PAS agencies must train attendants 16 hours up front.
- Last Verified
- September 2026 against No state license for non-medical care. Montana DPHHS licenses home health agencies and enrolls Medicaid providers. regulations
Typical timeline (estimate)
This is our best guess. Check with the No state license for non-medical care. Montana DPHHS licenses home health agencies and enrolls Medicaid providers..
Residents Age 70+
Moderate Opportunity
How Montana compares to neighboring states
| State | License Fee | Timeline | Startup Cost |
|---|---|---|---|
| Montana ← | $0 (no license) | 1-3 months | $33,500 - $94,000 |
| Idaho | $0 (no license) | N/A - 90 Days | $25,000 - $50,000 |
| North Dakota | $0 (no license) | 4-8 Weeks | $25,000 - $50,000 |
| Wyoming | $0 (no license) | 2-4 Weeks (Non-Medical) | 3-6 Months (Skilled HHA) | $15,000 - $45,000 |
| South Dakota | $0 (no license) | 4-8 Weeks | $25,000 - $50,000 |
Montana Licensing Overview
The No state license for non-medical care. Montana DPHHS licenses home health agencies and enrolls Medicaid providers. oversees all non-medical agencies.Montana is one of a handful of states that does not require a specific state license to run a non-medical home care agency. You can start providing personal care, companionship, and homemaker services without a state-level home care license. You still need to form a legal business entity, get insurance, and follow all federal and state business rules. Skilled home health is different. That means nursing or therapy at home. Montana law says a home health agency must offer a registered nurse (MCA 50-5-101). It needs a DPHHS license. DPHHS gives a 6-month provisional license first. Then a surveyor visits you. Medicare certification is a separate step.
No State License for Non-Medical Care
Montana does not require a specific state license for non-medical home care agencies. You can provide personal care, companionship, and homemaker services after forming your business and getting insurance.
Business Registration Required
Register your LLC or corporation with the Montana Secretary of State. Get a federal EIN, open a business bank account, and meet any local business licensing or zoning rules.
Insurance & Workers' Comp
Montana law requires workers' comp once you hire anyone. Most agencies also carry general and professional liability. Medicaid PAS agencies must carry $1 million per event in general liability. Montana has no surety bond rule for these agencies.
Background Checks
We found no Montana law that requires background checks for private-pay care. Do them anyway. Check every owner, manager, and caregiver. It keeps your clients safe.
No Certificate of Need (CON)
Montana's Certificate of Need law now covers long-term care beds, like nursing homes (MCA 50-5-301). DPHHS says home health agencies do not need one. Non-medical agencies don't either. That makes it faster to start.
Estimated Startup Costs (2026)
Budget for $33,500 - $94,000 to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| Business formation & legal | $2,000 | $5,000 |
| Business registration & fees | $0 | $500 |
| Insurance (GL, PL, Workers' Comp) | $5,000 | $12,000 |
| Office space & setup | $3,000 | $10,000 |
| Policies & procedures development | $2,500 | $6,000 |
| Technology & software | $2,000 | $5,000 |
| Recruitment & training | $2,000 | $6,000 |
| Marketing & branding | $2,000 | $8,000 |
| Working capital (3-6 months) | $15,000 | $40,000 |
We map every cost and file your Montana license for you.
Montana Startup Timeline
1-2 weeks
Form your business entity
Register your LLC or corporation with the Montana Secretary of State. Get your EIN, open a business bank account, and register for any required state tax accounts.
2-4 weeks
Develop policies, procedures & compliance framework
Write policies covering client rights, HIPAA compliance, emergency preparedness, personnel management, and quality assurance. These must line up with state and federal rules.
2-3 weeks
Get insurance & complete registrations
Since Montana does not require a specific home care license for non-medical services, focus on getting general liability, professional liability, and workers' compensation insurance. Complete any local business registrations.
2-3 weeks
Set up operations & technology
Set up your office, pick home care management software, set up billing and payroll systems, and create your client intake and assessment processes.
2-4 weeks
Recruit, hire & train staff
Start recruiting caregivers and admin staff. Build orientation and training programs. All direct care workers should pass background checks and get proper training before seeing clients.
2-4 weeks
Launch operations & build referral network
Start marketing to referral sources in your area. If you want Medicaid clients, enroll with Montana Medicaid as a Personal Assistance Services (PAS) agency. That opens Community First Choice and Big Sky Waiver clients. Build relationships with hospitals, doctors, and discharge planners.
We can do all of them for you in Montana.
New 2026 Legal Mandates
ARM Title 37, Chapter 106 & MCA Title 50, Chapter 5
Ongoing - These are Montana's health care facility rules. They cover licensed home health agencies. They do not apply to non-medical agencies. You can still use them as a guide for good practice.
Background Checks (Best Practice)
Ongoing - We found no Montana law that makes private-pay agencies run background checks. Run them anyway. Check owners, managers, and caregivers. Medicaid programs may set their own rules.
Medicaid CFC/PAS Training Rules (DPHHS Policy AB-CFC/PAS 706)
Ongoing - Do you serve Medicaid CFC or PAS clients? Then each attendant needs 16 hours of basic training first. A licensed nurse oversees it. After the first year, they need 8 hours each year. Private-pay agencies have no set hours.
HIPAA Compliance
Ongoing - All home care agencies must follow federal health information privacy rules. Set up proper data handling, train staff on HIPAA, and have breach notification procedures in place.
Employment Law Compliance
Ongoing - Follow state and federal wage and hour laws. Montana is not an "at-will" state. After a worker's trial period ends, you need a good reason to fire them (MCA 39-2-904). Write a clear trial period into your handbook.
Our Montana licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
Montana's vast distances can make scheduling and supervision harder than expected. Keep your initial service area tight -- especially in rural regions -- and expand only after your staffing is stable.
- Workers' compensation: Montana's workers' comp law covers all employers and employees (MCA 39-71-401). There is no small-business exception.
- Criminal background checks: Not required by state law for private-pay care. Still, check every caregiver before they start.
- Training & orientation: Develop orientation and training programs that cover client rights, safety, infection control, emergency procedures, and dementia care basics. Montana sets no training hours for private-pay agencies. Medicaid CFC/PAS attendants need 16 hours of basic training up front. Then 8 hours a year, starting in year two.
- HIPAA training: All staff must be trained on HIPAA privacy rules and proper handling of client health information.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch Montana home care agencies start to finish.
Regional Market Opportunities
Montana has growing demand in its major metro areas, but big opportunities also exist in smaller communities and rural areas where there are not enough providers. Travel time is a real factor -- focus on tight service areas. The billing rates below are our estimates, not official numbers. Real rates depend on the town, the care needed, and who pays.
Billings
Largest city in Montana with the highest concentration of seniors and healthcare facilities.
Key: Strongest starting market with established referral networks. Most competitive area.
Missoula
University town with a growing senior population and strong healthcare community.
Key: Good mix of demand and quality of life for recruiting caregivers.
Bozeman
Fast-growing city with higher cost of living and increasing demand for in-home care.
Key: Higher rates possible due to affluent population, but caregiver recruiting is competitive.
Great Falls
Strong senior population with less competition than Billings or Missoula.
Key: Underserved market with good potential for new agencies.
Helena / Kalispell
State capital and Flathead Valley areas with steady demand and limited providers.
Key: Helena has government worker retirees; Kalispell draws retirees to the Flathead Lake area.
Cost of care in Montana
What agencies charge clients vs. what caregivers earn in Montana. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$39
Avg. hourly rate charged to clients
$22.40
Avg. caregiver hourly wage
$16.60
Gross margin per hour
43%
Gross margin %
What this means for agency owners
In Montana, agencies keep roughly $16.60 per billable hour after paying the caregiver. That's a 43% gross margin.
This is a strong margin that gives you room to cover overhead costs (insurance, admin, marketing, compliance) and still run a profitable agency.
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.
Montana Medicaid Programs
Community First Choice / Personal Assistance Services (CFC/PAS)
Montana Medicaid's main personal care program. Agency-based providers send trained personal care attendants to help with daily tasks at home. Run by the DPHHS Senior and Long Term Care Division.
Agency Angle: To enroll, you need general liability insurance ($1 million per event, $2 million total). You also need car insurance for staff driving, workers' comp, and unemployment insurance (ARM 37.40.1013 for CFC; ARM 37.40.1122 for PAS). Each attendant needs 16 hours of basic training, then 8 hours a year. A nurse supervisor oversees care.
Big Sky Waiver (HCBS)
Montana Medicaid home and community-based services are delivered through the Big Sky Waiver program. This program helps seniors and people with disabilities get care at home instead of in a facility.
Agency Angle: Enrolling as a Medicaid provider is essential if you plan to serve Medicaid-eligible clients. Treat Medicaid enrollment as a separate workstream -- credentialing, compliance, and billing requirements take time to set up.
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
Montana Licensing FAQ
Do I need a license to start a home care agency in Montana?
Montana does not currently require a specific state license for non-medical home care agencies providing personal care, companionship, and homemaker services. You still need to form a legal business entity, get proper insurance, and follow all federal and state business and employment rules. For home health (skilled nursing), you need a DPHHS license. Medicare certification is a separate step.
Does Montana require a Certificate of Need for home care?
No. Montana's Certificate of Need law now covers long-term care beds, like nursing homes (MCA 50-5-301). DPHHS says home health agencies do not need one. Non-medical agencies don't either.
How much does it cost to start a home care agency in Montana?
Total startup costs for a home care agency in Montana typically range from $33,500 to $94,000. This includes business formation, insurance, technology, marketing, and working capital. Agencies targeting larger metro areas like Billings or Bozeman should budget toward the higher end due to more competition and higher cost of living.
How long does it take to start a home care agency in Montana?
Montana has no state license for non-medical home care. So there is no state review to wait for. Most owners can open in about 1-3 months. That is our estimate. It depends on how fast you set up your business, insurance, policies, and staff.
What are the biggest challenges of starting a home care agency in Montana?
Key challenges include recruiting quality caregivers in a competitive market, building strong referral relationships with healthcare providers, navigating Medicaid enrollment if serving Medicaid clients, and managing vast distances between clients in rural areas. Despite these challenges, Montana's growing senior population and favorable market conditions make it a good state for new home care agencies.
Is Montana a good market for home care agencies?
Montana has about 254,000 adults age 65 and older. That is about 22% of the state (Census, 2025). The senior population keeps growing as Baby Boomers age. The combination of growing demand, no state license requirement for non-medical care, and no Certificate of Need makes Montana an attractive state for home care entrepreneurs.
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
Idaho
No state license required · N/A - 90 Days
North Dakota
No state license required · 4-8 Weeks
Wyoming
No state license required · 2-4 Weeks (Non-Medical) | 3-6 Months (Skilled HHA)
South Dakota
No state license required · 4-8 Weeks
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Sizing up the competition? See the 575 home care agencies already operating in Montana →
Home care agencies in Montana
Want to see the competition up close? Look at who is already open, city by city.
- Home care agencies in Billings
- Home care agencies in Bozeman
- Home care agencies in Great Falls
- Home care agencies in Kalispell
- Home care agencies in Cameron Park
Looking for care for a family member? Find agencies near you
Considering other states?
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Nebraska
- Nevada
- New Hampshire
- New Jersey
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- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Where our numbers come from
We check each fact against Montana's own rules. Tap a source to read it yourself.
- License needed?NoMCA 50-5-101· Oct 2026
- Who oversees itNo state license for non-medical care. Montana DPHHS licenses home health agencies and enrolls Medicaid providers.MCA 50-5-101· Oct 2026
- License name—MCA 50-5-101· Oct 2026
- The rulesNo state non-medical license; MCA 50-5-101 (home health agency must provide RN services)MCA 50-5-101· Oct 2026
- First license feeno feeMCA 50-5-101· Oct 2026
- License lasts—MCA 50-5-101· Oct 2026
- BondNoneMCA 50-5-101· Oct 2026
- Owner/manager trainingNo state minimumMCA 50-5-101· Oct 2026
- Caregiver trainingNo state minimumMCA 50-5-101· Oct 2026
- Background checksNo state requirement found for private-pay non-medical agenciesBest guess — not confirmed yet
- How long it takes1-3 monthsBest 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.