Certification Guide
Home health Medicare certification process: 2026 step-by-step guide
The honest home health Medicare certification process step-by-step for 2026: 7 steps, 12-18 month timeline, and the full cost breakdown to plan around.
Quick answer
- Total time: 12-18 months from formation to Medicare provider number.
- Total cost: $30,000-$80,000 in fees + $100K-$200K working capital before Medicare revenue.
- 3 accrediting bodies: CHAP, ACHC, Joint Commission.
- Required: state license + 10 patient survey + accreditation survey + CMS-855A.
- AveeCare is non-medical home care; pair with Kinnser/KanTime/Axxess for skilled HH side.
7-step Medicare certification process
Step 1
Form entity, obtain EIN, NPI, secure office, meet state HH licensure requirements.
Step 2
Hire required staff (administrator, DON, clinicians) and write CoP-compliant policies.
Step 3
Begin operations under state license; serve at least 10 Medicare-eligible patients.
Step 4
Apply for CHAP, ACHC, or Joint Commission accreditation.
Step 5
Pass accreditation survey (clinical record review, on-site visit, interviews).
Step 6
Submit CMS-855A enrollment to your MAC (Medicare Administrative Contractor).
Step 7
Receive Medicare provider number, start billing 837I claims.
12-18 month timeline
| Months | Milestone |
|---|---|
| Months 1-3 | Entity formation; state licensure; hire admin + DON |
| Months 4-6 | Hire clinicians; write CoP policies; begin patient operations |
| Months 7-9 | Reach 10-patient threshold; apply for accreditation |
| Months 10-12 | Accreditation survey; address findings; gain accreditation |
| Months 13-15 | Submit CMS-855A; MAC review; provider number |
| Months 16-18 | First Medicare claims; PDGM optimization; revenue ramp |
3 accrediting bodies
CHAP (Community Health Accreditation Partner)
Most common for home health. Strong continuous-improvement framework. Application fee + survey ~$10K-$20K total.
ACHC (Accreditation Commission for Health Care)
Common for HH + DME + hospice. Application fee + survey ~$8K-$18K total.
Joint Commission
More common for larger multi-line organizations (hospital-affiliated HH). Higher fees but globally recognized.
AveeCare's role in your Medicare certification
AveeCare is non-medical home care software. For skilled HH Medicare certification, you need a Medicare HH-capable EMR. AveeCare runs the non-medical home care line of hybrid agencies at $6 / active client / month.
Contact us firstFrequently asked questions
The process: (1) form the entity and meet your state home health licensure requirements; (2) hire required staff and write policies meeting CMS Conditions of Participation (CoP); (3) start operations and serve at least 10 patients; (4) apply for CHAP, ACHC, or Joint Commission accreditation; (5) pass the accreditation survey; (6) submit CMS-855A enrollment to your MAC; (7) receive Medicare provider number and start billing. Timeline: 12-18 months end-to-end.
CMS recognizes three accrediting organizations for home health: (1) CHAP (Community Health Accreditation Partner), (2) ACHC (Accreditation Commission for Health Care), (3) Joint Commission. Each has slightly different standards, fees, and survey processes. CHAP and ACHC dominate the home health market; Joint Commission is more common for larger multi-line organizations.
Total cost typically runs $30,000-$80,000 spread over 12-18 months. Components: state licensure $500-$2,000, accreditation application fee $5,000-$15,000, accreditation survey fee $5,000-$15,000, EMR + EVV setup $5,000-$15,000, initial staff payroll before Medicare revenue $20,000-$40,000+. Most agencies need $100,000-$200,000 in working capital before Medicare revenue starts flowing.
AveeCare is non-medical home care software, not a Medicare HH platform. Agencies pursuing Medicare certification need a Medicare HH-capable EMR (Kinnser, KanTime, Axxess, Alora, MatrixCare). Hybrid agencies that operate non-medical home care alongside skilled HH often use AveeCare for the personal-care side at $6 per active client per month while running a Medicare HH platform for the skilled side.
Continue Reading
Run hybrid HH + non-medical home care?
$6 / active client / month for the home care side.