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North Carolina · License fees and time frames · G.S. 131E-138(c)
DHSR charges $510 for a North Carolina home care agency license, and the same every year to renew it. It sets no time frame for licensing you, but gives you 12 months from receiving your application to finish. Here is every state fee, the costs DHSR does not set, and each step from training to your first renewal.
Quick answer
Cost: DHSR’s fee for a North Carolina home care agency license is $510, and the license lasts one year. A change of ownership costs $510 and so does each annual renewal. "All fees are non-refundable." Each site needs its own license and application.
Time: DHSR does not promise a processing time: "Therefore, it is not possible to establish specific time frames." What is fixed is your deadline. You must complete every requirement within 12 months of DHSR receiving your application and fee.
DHSR does not set the other start-up costs, such as the owner training (from a private DHSR-approved trainer), staff criminal history checks, or the director and RN you employ.
Every amount below is a state fee paid to the N.C. Division of Health Service Regulation (DHSR). The statute sets it: "The Department shall charge the applicant a nonrefundable annual license fee in the amount of five hundred ten dollars ($510.00)."
| What for | DHSR fee | Notes | Source |
|---|---|---|---|
| Initial license | $510 | Sent with your application. The license lasts one year and expires at midnight on December 31. | G.S. 131E-138(c); FAQ 12 |
| Change of ownership | $510 | Tell DHSR in writing at least 30 days before the change takes effect. DHSR only processes it for an agency with a valid license. | DHSR FAQ 12, 30 |
| Annual renewal | $510 | Every year. DHSR must receive the renewal application and fee by December 31 for a January 1 effective date. | DHSR FAQ 12, 26 |
All three fees are non-refundable (DHSR FAQ 12). Pay by check, money order or certified check made payable to the N.C. Division of Health Service Regulation. DHSR Each agency site is licensed separately and needs its own application. 13J .0902
The licensing rules require each of these, but the price is up to whoever provides them. We do not quote typical prices, because no official source publishes them.
If you cannot show DHSR you have owned or operated a home care agency, it will not license you until you finish training it approves. DHSR does not run the training. Its training page lists nine approved private trainers with their contact details and no prices, so the price is whatever the trainer you choose charges.
13J .0903(a); DHSR training pageDHSR’s list of approved trainers ↗
An offer for a job that involves going into clients’ homes is conditional on a criminal history check, requested within five business days of the offer through the State Bureau of Investigation or a private entity. G.S. 131E-265 sets out the check but not a price for it.
An agency director who meets 13J .1001(b), and for in-home aide services an RN available while aides work. DHSR checks their files in the personnel documents you send. What you pay them is up to you.
DHSR reviews your policies, procedures and personnel documents before it licenses you. Its Initial Survey Checklist lists 32 policy and procedure items.
CareRulebook
The initial survey is a review of your policies, procedures and personnel documents. CareRulebook writes the North Carolina policies DHSR’s checklist asks for, with your agency’s details filled in and the 13J rule quoted under every policy.
$199CareRulebook founding price for the first 50 North Carolina agencies, then $249. Not a DHSR fee.
From 10A NCAC 13J .0903, DHSR’s Requirements for Establishing a Home Care Agency and its FAQ (revised May 30, 2025). The rules fix your deadlines, not DHSR’s. Tick steps off as you go; progress is saved in this browser only.
Unless you can show DHSR you have owned or operated a home care agency before. Keep the certificate: it goes in with your application.
Write your policies and procedures and prepare personnel files for the staff who will provide each service. DHSR recommends being prepared for the initial survey before you apply, and uses its Initial Survey Checklist as the guide.
The application (DHSR-4204), a check, money order or certified check payable to the N.C. Division of Health Service Regulation, and your training certificate or proof of past ownership. Your 12 months start when DHSR receives the application and fee.
DHSR reviews the packet for accuracy and completeness and emails to confirm it has your application and fee.
DHSR emails to request them. Personnel records should show staff for each service you will provide. DHSR does not return what you send.
A review of your policies, procedures and personnel documents against the licensing rules. DHSR may ask for more information, and sets no time frame for this stage.
If nothing more is needed, DHSR emails the approval letter and instructions to print the license from its Enterprise system. Every requirement must be complete within 12 months of DHSR receiving your application and fee.
Every license expires at midnight on December 31. DHSR must receive the renewal application and fee by December 31 for the renewal to take effect on January 1.
DHSR inspects each home care agency at least every three years, unannounced. If it cites deficiencies, file a plan of correction within 10 working days of receiving them.
For the form itself, where to mail it and what each section asks, see the North Carolina license application. For what DHSR looks for in your documents, see the initial survey.
DHSR does not publish an average and does not commit to a processing time. In its own words: "The length of the Initial Licensure process varies depending on multiple factors such as whether the application is complete, whether additional information needs to be submitted, current surveyor workload and availability of resources necessary to complete the review." DHSR FAQ 13
Two of those factors are in your hands:
The other two, surveyor workload and the resources DHSR has for reviews, are not. That is why DHSR recommends being ready for the initial survey before you apply: the 12-month clock starts when DHSR receives your application and fee, not when you are ready. DHSR
One timing point to plan for: every North Carolina home care license expires at midnight on December 31, whenever in the year it was issued. DHSR’s FAQ does not say how it handles a first renewal for an agency licensed late in the year, so if your approval is likely in the fall, ask the Acute and Home Care Licensure and Certification Section on 919-855-4620 when to send your first renewal. DHSR FAQ 24
"After initial licensure, the agency must have the license renewed every year." DHSR The rule says each license "shall expire at midnight on the expiration date on the license and is renewable upon application." 13J .0903(b)
"The completed renewal application and the license renewal fee must be received no later than December 31 to ensure your license is renewed with an effective date of January 1." "License renewal applications received after January 1st shall be effective the date received." DHSR FAQ 26
If you miss it, DHSR says "If you do not renew your home care license prior to the expiration date, you will be operating without a license", and you may be referred to the Division of Health Benefits (Medicaid) or other funders. "Failure to renew your home care license may also affect your ability to be an enrolled Provider with DHB." DHSR FAQ 27
Mail the renewal in good time so DHSR receives it by December 31. More on renewing and reporting changes →
DHSR says the main reason applicants are not approved is that they do not understand or comply with the initial survey checklist and the licensing rules. Missing the minimum requirements may delay licensure.
DHSREvery requirement must be complete within 12 months of DHSR receiving your application and fee. The fee is not refundable.
DHSR checklist; G.S. 131E-138(c)Personnel records must show proof of staff to provide each service you applied for, with every applicable item in 13J .1003(f).
DHSR FAQ 16A renewal DHSR receives after January 1 takes effect on the date received, and until then you are operating without a license. That can lead to a referral to Medicaid (DHB) or other funders.
DHSR FAQ 26-27DHSR only processes a change of ownership for an agency with a valid license, and the license itself does not transfer.
DHSR FAQ 30; 13J .0903(d)Knowingly and willfully operating a home care agency without a license is a Class 3 misdemeanor, with a fine of up to $500 for each offense.
G.S. 131E-141.1The DHSR license is the first step, not the last, if you plan to serve Medicaid clients. To bill Medicaid for personal care services (PCS), a provider must be "a home care agency licensed by the DHSR to operate in the county or counties where the PCS Services are being provided", and must also "have a current and signed Department of Health and Human Services (DHHS) Provider Administrative Participation Agreement". Policy 3L, 6.0-6.1
So Medicaid enrollment comes after licensing, on its own timeline. DHSR reminds agencies that "DHB (DMA), NC Tracks and DHSR are separate entities." DHSR FAQ 40
No. DHSR says the initial licensing process varies with how complete the application is, whether more information is needed, and surveyor workload, so it does not set specific time frames. What is fixed is your deadline: everything must be complete within 12 months of DHSR receiving your application and fee.
"Therefore, it is not possible to establish specific time frames."
No. The statute sets a nonrefundable annual license fee of $510, and DHSR’s FAQ says all of its home care license fees are non-refundable.
"The Department shall charge the applicant a nonrefundable annual license fee in the amount of five hundred ten dollars ($510.00)."
No. DHSR approves the training but does not run it. It lists the private trainers it has approved on its website.
"The Division of Health Service Regulation does not provide home care provider training."
No. Not only. The statute requires an inspection at least every three years, but a licensed agency is subject to inspection at any time, and DHSR also carries out complaint investigations, which are unannounced too.
"Any agency licensed by the Department shall be subject to proper inspections by authorized representatives of the Department at any time as a condition of holding such license."
DHSR charges $510 for an initial home care agency license, $510 for a change of ownership and $510 a year to renew. All fees are non-refundable. These are state fees paid to the N.C. Division of Health Service Regulation, not CareRulebook prices.
DHSR does not set a time frame. It says the initial licensing process varies with whether the application is complete, whether more information is needed, surveyor workload and the resources available for the review. You must complete every requirement within 12 months of DHSR receiving your application and fee.
No. G.S. 131E-138(c) sets a nonrefundable annual license fee of $510, and DHSR’s FAQ says all of its home care license fees are non-refundable.
DHSR does not set the price. It does not run the training; it lists approved private trainers on its Home Care Provider Training page, without prices. Ask the trainers on that list for their current fees.
Every year. All home care licenses expire at midnight on December 31, and DHSR must receive the renewal application and the $510 fee by December 31 for the renewal to take effect on January 1. Renewals received after January 1 take effect on the date received.
DHSR says that if you do not renew before the expiration date you will be operating without a license and may be referred to the Division of Health Benefits (Medicaid) or other funders. It can also affect your ability to stay an enrolled Medicaid provider.
Each agency site needs its own license and its own application, and DHSR asks for the fee with each application. Budget for a separate $510 application for each site.
The General Assembly sets the license fee, the Medical Care Commission makes the home care rules and DHSR updates its checklist and FAQ. Leave your email and we will tell you when a change affects your fees, deadlines or policies.
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