How to Start a Home Care Agency in Texas — HCSSA License Guide 2026

What is an HCSSA?

In Texas, non-medical home care agencies are licensed as Home and Community Support Services Agencies (HCSSA) under Texas Health and Human Services Commission (HHSC). You must be HCSSA-licensed before providing any home care services in the state.

The licensing process

Complete the pre-survey computer-based training, submit your application through TULIP (Texas Unified Licensure Information Portal), upload required documents, pay license fees, and pass the initial survey. The process typically takes 3-6 months.

Key requirements

You need a registered business in good standing with the Texas Secretary of State and Comptroller, a qualified administrator and alternate administrator, documented policies and procedures, and a physical office location (no virtual addresses allowed under TAC §558).

EVV from day one

Texas requires EVV for all Medicaid personal care and home health services through HHAeXchange. Set up your EVV system before enrolling your first Medicaid client. Tendara connects directly to HHAeXchange.

Launching a Texas agency? See how Tendara supports HCSSA providers.