How to start a home care agency in New Mexico and reach your first client faster
New Mexico draws its licensing line at medically directed care, not at medical tasks. A companion and personal care agency with no physician reviewed plan of care needs no state license, but the same services under a physician's plan make you a licensed home health agency. Medicaid adds its own track: PCS agency certification, a contract with each Turquoise Care health plan, fingerprint screening within 20 days of hire, registry checks and EVV. We put all of it in the right order for you.
- Guides reviewed by Christine Ochimas, RN, LMFT, MBA
- One fixed price, agreed in writing
- You own 100%. No franchise fees or royalties
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- Christine OchimasRN, LMFT, MBA
- All three care typesNonmedical, home health, hospice
- Written to New Mexico rulesthe Turquoise Care Managed Care Policy Manual, Section 8, and 8.370 NMAC
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Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA
Answer two questions. See exactly what New Mexico requires.
Personal care services for Turquoise Care members
- State license
- No HCA license needed; Medicaid PCS agency certification instead (8.308.12 NMAC and Managed Care Policy Manual Section 8)
- Who you deal with
- HCA Medical Assistance Division and each Turquoise Care health plan in your counties
- Must haves
- Medicaid enrollment at YES.NM.GOV, PCS agency certification packet and mandatory training, health plan contracts, fingerprint screening within 20 days of hire, Employee Abuse Registry checks, CPR, first aid and competency testing, EVV
- Realistic time to first client
- Several months
Orientation for New Mexico only. We confirm your exact path on the free call.
Three places new New Mexico agencies lose months
Each one keeps you paying rent, insurance and payroll while no clients arrive.
Landing on the wrong side of the medically directed line
New Mexico's home health rule covers any agency providing medically directed services, and that includes personal care attendants and homemakers working under a plan of care a physician reviews. Owners who call themselves nonmedical but take physician orders are operating a home health agency without a license. Others file for a home health license they never needed and wait months for a survey.
What it costs: Months on the wrong application, or enforcement risk for running an unlicensed home health agency.
Certification, then four health plans
Medicaid personal care services run through Turquoise Care. An agency first needs HCA PCS agency certification and a mandatory HCA training session, then a contract with each health plan it wants referrals from. Certification is tied to the county of your office, and you must serve every part of that county.
What it costs: Months of rent, insurance and payroll carried by your operating reserve while certification and plan contracts are pending.
Attendant files that fail the annual audit
A 2024 federal Office of Inspector General audit found New Mexico did not ensure personal care attendants were qualified. HCA now directs the Turquoise Care plans to audit every agency based provider each year and check background screening, abuse registry checks, TB tests, competency tests, annual training, and CPR and first aid.
What it costs: Corrective action plans, recovered payments for undocumented visits, and in repeated cases the loss of a plan contract.
What does a delay cost your agency?
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Home care vs home health vs hospice in New Mexico
The three sound alike and are regulated differently. The one you choose decides your regulator, staffing, startup capital and timeline.
| Topic | Nonmedical home care | Home health (skilled) | Hospice |
|---|---|---|---|
| What your staff do | Personal care, homemaker tasks, companionship, respite, when no physician directs the plan of care | Skilled nursing, therapies, home health aides, and attendant or homemaker services under a physician reviewed plan of care | Palliative and supportive care for people who are terminally ill, and their families |
| State license | None; Medicaid PCS agencies need HCA certification | HCA home health agency license (8.370.22 NMAC) | HCA hospice license (8.370.19 NMAC) |
| Certificate of Need | No | No Certificate of Need step | No Certificate of Need step |
| Main payers | Private pay, Turquoise Care health plans (personal care services and respite), programs funded by the Aging and Long Term Services Department | Medicare, Turquoise Care health plans, commercial insurance | Medicare hospice benefit, Medicaid |
| Medicare | Not covered | Accreditation or state survey, then Medicare enrollment; check the CMS moratorium | Accreditation or state survey, then Medicare enrollment; check the CMS moratorium |
| Key staff | Supervisor for monthly Medicaid supervisory visits; screened, trained and tested attendants | Administrator, supervising RN or therapist, advisory group of at least three, clinical staff | Administrator, physician, RN care coordinator, social worker, pastoral or other counselor |
| Startup capital | Lowest | Higher: clinical payroll before Medicare revenue | Highest: interdisciplinary team before revenue |
| Time to first client | Weeks (private pay) to months (Turquoise Care) | Longest: licensure, survey, enrollment | Longest: licensure, survey, enrollment |
Many New Mexico owners start with nonmedical personal care, build cash flow and a caregiver team, then add a licensed home health agency. A licensed home health agency may also provide services that are not medically directed, and HCA accepts a current home health license in place of much of the Medicaid PCS certification packet. We plan both from day one so your policies and hiring grow with you instead of being rewritten.
New Mexico requirements at a glance
| Nonmedical home care license | None for care that is not medically directed (8.370.22.7 NMAC). Medicaid personal care agencies need HCA PCS agency certification. |
|---|---|
| Home health and hospice licensing | New Mexico Health Care Authority (HCA), Division of Health Improvement, Health Facility Licensing and Certification Bureau, under 8.370.22 NMAC (home health) and 8.370.19 NMAC (hospice). Fees are in 8.370.3 NMAC. |
| Medicaid agency | HCA Medical Assistance Division. Providers enroll through the HCA Provider Enrollment System at YES.NM.GOV. |
| Medicaid home care program | Turquoise Care managed care (since July 1, 2024): Community Benefit services, agency based or self directed, through four health plans |
| Caregiver training | Licensed home health agencies: 75 hours for home health aides and 40 hours in the first year for attendants and homemakers (10 before placement). Medicaid PCS attendants: CPR, first aid and a written competency test within three months of hire, then 12 hours a year. |
| Background screening | Fingerprint based screening under the Caregivers Criminal History Screening Act and 8.370.5 NMAC, submitted within 20 calendar days of hire; Employee Abuse Registry check before hire (8.370.8 NMAC) |
| Electronic visit verification | Required for payment of Medicaid personal care services. AuthentiCare is the state and health plan system; since May 2026 agencies may send data from an approved third party system instead. |
| Certificate of Need | No Certificate of Need step for home care, home health or hospice |
| Medicare (home health, hospice) | Accreditation by a CMS approved organization or a state survey, then Medicare enrollment. A CMS moratorium on new enrollments began May 13, 2026. |
| Entity and tax filing | New Mexico Secretary of State for the entity; Taxation and Revenue Department for a Business Tax Identification Number covering gross receipts and wage withholding |
Summary of New Mexico requirements as of November 2026. Rules change; confirm with each agency before filing.
Step by step: launching a home care agency in New Mexico
The order matters. Steps 5 and 6 should start long before step 7, because health plan contracts follow Medicaid enrollment and PCS certification, and the certification packet must already include passed screenings for your caregivers.
Form the business with the Secretary of State
File your LLC or corporation, get an EIN, register with the Taxation and Revenue Department for a Business Tax Identification Number (gross receipts and wage withholding), open your state unemployment insurance account, and get a city or county business license. Medicaid certification asks for a current business license every year.
You do this; we give you the checklistDecide your payer mix and where the line sits
Private pay, Turquoise Care or both, and whether any client's care will follow a physician reviewed plan. That single question decides whether you need a home health license. Use the path finder above.
Decided on your free consultationSet up insurance and employment basics
Arrange workers' compensation and liability insurance (Medicaid asks for proof of both every year), plus auto coverage for caregivers who drive clients. Build earned sick leave under the New Mexico Healthy Workplaces Act into payroll from the first hire.
You do this; we specify what is requiredWrite policies to the Section 8 standard
Adopt policies on Medicaid PCS rules, personnel, office details, quarterly quality improvement, incident management and confidentiality, plus a written attendant competency test covering the subjects HCA lists. Write them to the Turquoise Care Managed Care Policy Manual, Section 8, and cite the current 8.370 NMAC rules.
We write this for youBuild the caregiver pipeline
Check the Employee Abuse Registry before hire and every year, submit fingerprints for criminal history screening within 20 calendar days of hire, follow DOH and CDC guidance on TB, offer the Hepatitis B vaccine, and get CPR, first aid and a passed competency test (80% or more) within three months. Track 12 hours of training a year.
We set up the system and trackerEnroll with Medicaid and get PCS certification
Create an account at YES.NM.GOV and enroll in the HCA Provider Enrollment System. Submit the PCS certification packet: the provider participation agreement (MAD 335), passed screenings, business license, insurance and policies. Choose the county for your office, then attend HCA's mandatory provider training before delivering services.
We prepare and manage itContract with Turquoise Care health plans
Turquoise Care members are served by Blue Cross Blue Shield of New Mexico, Molina Healthcare of New Mexico, Presbyterian Health Plan and UnitedHealthcare Community Plan of New Mexico. Apply to each plan and complete its credentialing. Plan contracts, not certification alone, bring referrals.
We prepare every plan's packetSet up electronic visit verification
EVV is required for Medicaid personal care payment, and HCA expects approved agencies to finish EVV training within 30 days of contracting with the plans. Use AuthentiCare, or an approved third party system that sends visits to the AuthentiCare aggregator at your own cost.
We walk you through setup
Caregiver training and background checks
New Mexico sets two training standards. Licensed home health agencies follow 8.370.22 NMAC for aides, attendants and homemakers. Medicaid personal care attendants follow the Turquoise Care Managed Care Policy Manual, Section 8. Screening and registry rules apply across licensed and Medicaid providers.
- Home health aides: In a licensed home health agency, at least 75 hours of classroom and supervised practical training, with at least 16 hours of supervised practical training after 16 classroom hours, or a competency evaluation. Then 12 hours of in service training every year. HCA must approve an agency's own curriculum before it trains.
- Attendants and homemakers in a licensed agency: At least 40 hours of training in the first year of employment, 10 of them before the caregiver is placed in a client's home, covering subjects such as client rights, infection control, emergency response with CPR and first aid, and home safety.
- Medicaid PCS attendants: For agency delegated care: CPR and first aid certification and a written competency test passed with at least 80% within the first three months, then 12 hours of training a year paid for by the agency.
- Criminal history screening: Fingerprint based state and nationwide screening under the Caregivers Criminal History Screening Act and 8.370.5 NMAC. Submit fees and paperwork within 20 calendar days of the first day of work. The caregiver may work under supervision while waiting for HCA's written result.
- Prior screening: A caregiver whose nationwide screening in the past 12 months showed no disqualifying conviction needs only a statewide screening at the new job.
- Employee Abuse Registry: 8.370.8 NMAC requires providers, including home health and homemaker agencies, to check the registry before hiring and bars hiring anyone listed. Medicaid PCS agencies also check it every year.
- Supervisory visits: Licensed home health agencies visit at least every 62 days for aides, attendants and homemakers. Medicaid PCS agencies make face to face visits at least monthly, 12 per plan year.
- TB and Hepatitis B: Home health staff with patient contact need a TB test. PCS agencies follow DOH and CDC TB guidance and offer the Hepatitis B vaccine at hire at no cost, documenting acceptance or refusal.
Six mistakes that slow New Mexico agencies down
We look for every one of these in the first week of an engagement.
Taking physician orders without a home health license
- What it costs
- Services under a physician reviewed plan of care make you a home health agency, and operating one without a license breaks the Public Health Act.
- How we prevent it
- Clear service definitions and intake rules so a nonmedical agency never works under physician directed plans.
Missing the 20 day screening deadline
- What it costs
- Late submissions are grounds for sanctions under the Caregivers Criminal History Screening Act and fail Medicaid audits.
- How we prevent it
- A tracker that starts the 20 day clock on each caregiver's first day of work.
Letting the temporary license run out
- What it costs
- A home health temporary license lasts up to 120 days, and no more than two in a row may be issued. Without a survey in that window, admissions stop.
- How we prevent it
- We plan your first admissions and the written survey request around the temporary license dates.
Citing repealed rules in your policies
- What it costs
- Policies that still cite 7.28.2 or 7.1.9 NMAC look out of date to surveyors and auditors. Those rules were replaced on July 1, 2024.
- How we prevent it
- We write your manual to the current 8.370.22, 8.370.5 and 8.370.8 NMAC and the current Section 8 manual.
Contracting with only one Turquoise Care plan
- What it costs
- Referrals from only one plan's members, since members choose among four health plans.
- How we prevent it
- We prepare packets for every plan serving your counties at once.
Mixing up supervisory visit rules
- What it costs
- A 62 day schedule meets the home health rule but not the monthly face to face visits Medicaid requires for agency delegated personal care.
- How we prevent it
- A visit calendar built for each payer and each client's plan of care.
In a free 30 minute call we confirm your New Mexico path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.
New Mexico launch packages
Three fixed price packages, matched to the path you choose. Your exact price is quoted in writing after your free call, before any work starts.
Private pay launch
For nonmedical agencies serving families who pay privately.
- New Mexico path and a dated launch plan
- Policy and procedure manual written to the Turquoise Care Managed Care Policy Manual, Section 8, and 8.370 NMAC
- Service agreement, client rights and care plan forms
- Caregiver hiring and screening workflow
- Google Business Profile setup
Turquoise Care ready agency
Everything in Private pay launch, plus the Medicaid route.
- Policies aligned to Turquoise Care requirements
- Caregiver training and background check tracker
- Medicaid provider enrollment
- Credentialing packets for each Turquoise Care health plan in your counties
- Survey and audit readiness
- New Mexico city pages for local search
Home health and Medicare
For skilled home health. Hospice is scoped separately.
- Staffing and capital timeline
- Policies written to HCA rules and the Medicare Conditions of Participation
- License application and inspection readiness
- Accreditation survey preparation
- Medicare and Medicaid enrollment support
Every package: one fixed price agreed in writing · you own 100% of your agency · no franchise fees or royalties.
On your own vs a franchise vs Lunaria
| Topic | On your own | Home care franchise | With Lunaria |
|---|---|---|---|
| Who owns the business | You | You, under the franchisor's brand and rules | You, 100% |
| Ongoing fees | None | Royalties and brand fees, usually a share of revenue | None. One fixed project fee |
| Knowing what New Mexico requires | Pieced together from manuals and forums | A national playbook, adapted | Confirmed on your first call, then in writing |
| Policy manual | A template, often from another state | The franchisor's standard manual | Written to the Turquoise Care Managed Care Policy Manual, Section 8, and 8.370 NMAC |
| Medicaid credentialing | One application at a time | Varies by franchisor | Packets for each Turquoise Care health plan in your counties prepared together |
| Your brand and marketing | Up to you | The franchisor's brand, with territory limits | Your brand, plus local search set up for you |
The New Mexico home care startup checklist
Every New Mexico step in order: business setup, your payer path, policies, caregiver screening and training, Medicaid enrollment and getting found. The items to start first are starred.
- Choose your care type and payer mix, and confirm no client care will be physician directed
- Form your LLC or corporation with the New Mexico Secretary of State
- Get an EIN and a Business Tax Identification Number from the Taxation and Revenue Department
- Open your state unemployment insurance account and get a city or county business license
- Buy workers' compensation, liability and auto coverage
- and 14 more steps
Christine Ochimas, RN, LMFT, MBA
Christine founded Lunaria Care Consulting to give nurses and caregivers a direct route from "I want my own agency" to a compliant business with clients. She reads state requirements the way a reviewer does and writes policies the way a nurse would actually use them.
- We serve owners in all 50 states and DC, with a plan written for New Mexico
- We help through enrollment and survey readiness, not just the application
- We tell you what we cannot promise: no one can guarantee a state or health plan decision
Have these ready for your consultation
- The care you want to provide and the clients you want to serve
- The New Mexico cities or counties you plan to cover
- Where you are now: idea, business formed or already operating
- Who you expect to pay: families, Turquoise Care, Medicare
- Your target opening month and rough budget
No client or patient records. We never need them for a first call.
What it costs to start a home care agency in New Mexico
| Item | Notes |
|---|---|
| State license | None for care that is not medically directed. Under 8.370.3 NMAC, home health agencies and in home hospices pay $300 per license at initial and renewal application; the first temporary license is included in the initial fee. Fees are not refundable. |
| Second temporary or amended license | A second temporary license is charged before it is issued. Amended licenses, such as a change of administrator, name or address, cost $300 each. |
| Caregiver criminal history screening | FBI, Department of Public Safety and HCA processing fees per caregiver, plus the fingerprinting vendor. For Medicaid PCS, the agency pays for each attendant's first screening. Check current fees with HCA. |
| Entity formation and local license | Secretary of State filing fee plus any city or county business license |
| Training and testing | Aide or attendant training, competency testing, and CPR and first aid courses, paid by the agency for Medicaid attendants |
| Insurance | Workers' compensation, liability and auto coverage; Medicaid asks for proof every year |
| EVV and scheduling software | AuthentiCare is offered at no cost to providers; an approved third party EVV system is at the agency's cost |
| Accreditation (home health, hospice) | Accrediting organization application and survey fees |
| Operating reserve | Covers payroll, rent and insurance while certification, plan contracts or Medicare enrollment are pending |
Fees change. Confirm current amounts with each agency before budgeting.
How long it takes in New Mexico
Weeks, once the business, insurance, registry checks and hiring process are in place.
Several months: Medicaid enrollment, PCS agency certification and HCA training, then contracting and credentialing with each health plan.
Longest: HCA application, temporary license, initial survey, then accreditation or a certification survey and Medicare enrollment, subject to the CMS moratorium.
Most private pay demand sits in the Albuquerque metro, Santa Fe and Las Cruces, where families compare agencies online and expect bilingual service. Much of New Mexico is rural and spread out, and both the home health rule and Medicaid PCS certification tie your service area to roughly 100 miles from your office, so where you put that office decides which towns you can serve. Turquoise Care members choose among four health plans, which makes contracts with all of them matter. Many families search for care in Spanish, so Spanish pages and a complete Google Business Profile help you get found.
Frequently asked questions
Do you need a license to start a nonmedical home care agency in New Mexico?
Not if your services are not medically directed. 8.370.22 NMAC excludes agencies providing services that are not medically directed from the home health agency definition. If attendant or homemaker services follow a plan of care a physician reviews, you need a home health agency license from HCA. Medicaid personal care agencies need HCA PCS agency certification.
Who licenses home health and hospice agencies in New Mexico?
The New Mexico Health Care Authority, through its Division of Health Improvement and Health Facility Licensing and Certification Bureau. Home health rules are in 8.370.22 NMAC and hospice rules in 8.370.19 NMAC. These replaced the old Department of Health rules on July 1, 2024.
How much is a New Mexico home health agency license?
8.370.3 NMAC sets the fee at $300 per license for home health agencies and for in home hospices, charged at initial and renewal application. The first temporary license is included in the initial fee, and amended licenses cost $300. Fees are not refundable.
What is the difference between a state license and Medicare certification?
The HCA license lets a home health agency or hospice operate in New Mexico. Medicare certification, through an accreditation or state survey and Medicare enrollment, lets it bill Medicare. Most clinical agencies need both.
Can a new home health agency or hospice enroll in Medicare right now?
CMS placed a six month nationwide moratorium on new Medicare enrollment of home health agencies and hospices starting May 13, 2026. It was set to run until about November 13, 2026, and CMS can extend it in six month steps, so it may have ended or been extended by the time you read this. You can still get your HCA license while it is in place.
Does New Mexico require a Certificate of Need for home health or hospice?
No. The HCA licensing rules for home health agencies and hospices contain no Certificate of Need or need review. Licensure, survey and Medicare enrollment still apply.
How do New Mexico home care agencies get Turquoise Care clients?
By enrolling with Medicaid at YES.NM.GOV, completing HCA PCS agency certification and training, and contracting with the Turquoise Care health plans: Blue Cross Blue Shield of New Mexico, Molina Healthcare of New Mexico, Presbyterian Health Plan and UnitedHealthcare Community Plan of New Mexico. Each plan's care coordinators authorize services.
Do New Mexico caregivers need background checks?
Yes, at licensed agencies, Medicaid providers and programs funded by the Aging and Long Term Services Department. The Caregivers Criminal History Screening Act requires fingerprint based screening submitted within 20 calendar days of hire, and 8.370.8 NMAC requires an Employee Abuse Registry check before hire.
Is a franchise a better way to start a home care agency in New Mexico?
A franchise gives you a brand and playbook in exchange for fees and ongoing royalties. Starting independently with Lunaria costs one fixed price, and you own 100% of your agency with no franchise fees or royalties.
How much does New Mexico home care consulting cost?
Lunaria charges one fixed price per engagement, based on your path: private pay, Turquoise Care or home health and Medicare. You receive the price in writing after a free 30 minute consultation. There are no hourly charges.
Sources checked for this guide (21)
- 8.370.22 NMAC, Requirements for Home Health Agencies (effective 7/1/2024)
- 8.370.19 NMAC, Requirements for In Home and Inpatient Hospice Care (effective 7/1/2024)
- 8.370.3 NMAC, Health Facility Licensure Fees and Procedures (effective 1/28/2025)
- 8.370.5 NMAC, Caregivers Criminal History Screening Requirements
- 8.370.8 NMAC, Employee Abuse Registry
- 8.308.12 NMAC, Managed Care Program: Community Benefit
- HCA Turquoise Care Managed Care Policy Manual, Section 8: Agency Based Community Benefits (effective 12/22/2025)
- HCA Managed Care Policy Manual page (Internet Archive copy, June 2026)
- HCA Letter of Direction #25: HHS OIG Personal Care Services Audit Remediation (October 18, 2024)
- HCA Turquoise Care Overview (Internet Archive copy, October 2026)
- HCA New Provider and PED Enrollment System, YES.NM.GOV (Internet Archive copy, June 2026)
- Federal Register 2026-09717: nationwide moratorium on Medicare enrollment of home health agencies
- Federal Register 2026-09718: nationwide moratorium on Medicare enrollment of hospices
- CMS Provider Enrollment Moratoria
- CMS accreditation and approved accrediting organizations
- CMS-855A Medicare enrollment application, institutional providers
- 42 CFR Part 484, home health Conditions of Participation (Cornell LII)
- 42 CFR Part 418, hospice care (Cornell LII)
- New Mexico Taxation and Revenue Department: Who must register a business
- New Mexico Secretary of State, Business Services
- BCBSNM: AuthentiCare Data Aggregator, NM EVV implementation (health plan notice, 2026)
This guide is general information and reflects New Mexico requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the New Mexico Health Care Authority, Turquoise Care health plans and CMS before filing. Lunaria Care Consulting provides professional consulting services and does not provide legal advice.
Other states: see all state guides. What we do: licensing, compliance, Medicaid enrollment and local search marketing.