Texas is the second-largest home health agency market in the United States, with 1,849 Medicare-certified providers as of April 2026. The market spans major metros — Houston, Dallas–Fort Worth, San Antonio, and Austin — as well as rural counties with limited provider options. Texas has historically had a high density of proprietary agencies, and the state has been a focal point of CMS fraud enforcement actions, making star ratings and certification date especially important signals when evaluating providers.
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Texas has 1,849 active Medicare-certified home health agencies in the April 2026 CMS CASPER release. Houston's Harris County has the highest concentration, followed by Dallas County and Bexar County (San Antonio). The Texas market grew rapidly in the 2000s and early 2010s, driven by demographic trends and relatively accessible Medicare certification at the time. CMS subsequently tightened its moratorium on new agency certifications in Texas counties with unusually high Medicare billing, which has slowed new entrants in some markets.
Texas agencies show significant variance in star ratings across regions. Rural agencies and agencies with newer certification dates tend to have lower star ratings or no rating at all (CMS requires a minimum patient volume before publishing ratings). For referral coordinators and discharge planners working in Texas, filtering to 3-star or higher agencies and then applying geographic constraints is a reliable workflow. HHAdata's search lets you combine state, city, and minimum star rating filters simultaneously.
The vast majority of Texas home health agencies are proprietary (for-profit). Hospital-affiliated non-profit agencies operate in major metros but are a small share of the total market. The high concentration of proprietary agencies in Texas has historically correlated with more variable quality outcomes — a pattern documented in multiple CMS and OIG reports on Medicare home health utilization. Star ratings remain the most reliable publicly available quality signal.
In addition to Medicare certification, home health agencies in Texas must be licensed by the Texas Health and Human Services Commission (HHSC) as a Home and Community Support Services Agency (HCSSA). There are multiple HCSSA license types; agencies providing skilled nursing or therapy under Medicare Part A hold the "licensed and certified" designation. Verify both CMS certification number and active HHSC licensure when conducting due diligence on a Texas agency.
How many Medicare home health agencies are in Texas?
As of April 2026, Texas has 1,849 active Medicare-certified home health agencies in the CMS CASPER dataset.
Why are star ratings important for Texas home health agencies?
Texas has a large number of agencies with variable quality histories. CMS star ratings are the fastest way to identify higher-performing providers before conducting deeper due diligence.
What license does a home health agency need to operate in Texas?
Texas HHAs need both a CMS Certification Number (for Medicare billing) and a Texas HHSC Home and Community Support Services Agency (HCSSA) license.
Download the full Texas dataset — 1,849 agencies with star ratings, contact info, ownership type, and certification dates — as CSV or JSON.
Get Full Access →Data sourced from CMS CASPER (dataset 6jpm-sxkc). Updated monthly. Not affiliated with Medicare or CMS. Official source