How to Start a Home Health Agency in Wyoming: $150 State License, Facility Fee Table Under W.S. 35-2-904 and the 2026 Certificate-of-Need Repeal
Starting a home health agency in Wyoming means working through two separate tracks. The first is business formation: you register an entity with the Wyoming Secretary of State. The second is health facility licensing: the Wyoming Department of Health licenses home health agencies under W.S. 35-2-901 to -914, and the state fee for that license is $150. Neither track is optional, and the health license is the one that can stop you from opening your doors.
This guide covers the order we recommend, the fee table for every facility type listed in the statute, and what the 2026 changes to Wyoming's facility rules do and do not mean for a home health agency. This content is informational, not legal or tax advice. Before you sign a lease, hire staff or accept a Medicare or Medicaid patient, talk with a Wyoming attorney and a CPA, and confirm fees and requirements with the agency named in each step. Figures are current as of October 2026.
Materials and Information You Need Before You Start
- A business name that is available and distinguishable on the WyoBiz filing search
- A registered agent with a physical street address in Wyoming (a PO box can supplement the physical address but cannot replace it)
- Your entity's formation documents: Articles of Organization for an LLC or Articles of Incorporation for a profit corporation
- A written description of every service you will provide, so you can tell the Department whether your model is skilled care or non-medical care
- A federal Employer Identification Number from the IRS
- A business bank account and a cash reserve that covers state fees, insurance, payroll and rent until the first billable visit
- The street address of your office, so you can check with the city clerk where it sits about local licenses
- A calendar that tracks your Secretary of State annual report date and the June 30 health license year end
Step 1: Confirm Your Agency Needs the Home Health License
Under W.S. 35-2-901(a)(xi), a home health agency is an agency primarily engaged in arranging and directly providing nursing or other health care services to persons at their residence. An agency that provides skilled nursing, therapy or other health care in the home falls clearly within that definition. A companion, homemaker or personal-care only business is a different question. The Wyoming Department of Health, Office of Healthcare Licensing and Surveys, decides whether those services require this license, so do not assume either way.
Call or write the Office, describe your services in detail, and ask for the answer in writing before you spend money on formation. Keep that letter in your permanent file.
Step 2: Form the Entity With the Wyoming Secretary of State
Most owners form an LLC. The Articles of Organization filing fee is $100, and you can file on WyoBiz through the WyoBiz registration page. Online filings are active as soon as they are completed. Paper filings are processed in the order received and can take up to 15 business days.
Three name rules cause the most trouble. First, the name must include "Limited Liability Company" or an accepted abbreviation such as "LLC," "L.L.C.," "LC" or "Ltd. Liability Company" (W.S. 17-29-108). Second, search the WyoBiz filing search before you register. Third, entity names beginning with the letter "A" must be filed on paper rather than online.
If you need time to settle on a name, you can reserve it for 120 days for $60. The reservation is paper only, with no online option, so use the LLC name reservation form.
A corporation files Articles of Incorporation (Profit Corporation) for the same $100 filing fee. Wyoming levies no corporate income tax, no personal income tax and no franchise tax. The only recurring state entity charge is the annual report license tax.
If you will operate under a name other than your entity name, register a trade name. Registration is optional in Wyoming. It costs $100 for a 10 year term and $50 to renew, and it is filed with the Secretary of State, not the county clerk. The Application for Registration of Trade Name is mail-only and must be notarized. A trade name reservation is separate, at $30 for 120 days.
Appoint a Registered Agent
Every entity must continuously maintain a registered agent to accept service of process. The agent can be a Wyoming resident or an authorized business entity, and it must have a physical Wyoming street address, including any suite number. A drop box does not qualify. Commercial registered agents pay a $50 annual registration. Appointing a new agent and office later costs $5. The agent signs a Consent to Appointment certifying compliance with W.S. 17-28-101 through 17-28-111.
Calendar the Annual Report
The annual report license tax has a $60 minimum. It is due on the first day of the anniversary month of formation every year and may be filed up to 120 days early. If it is not paid within 60 days of the due date, the entity is subject to administrative dissolution. Entities with more than $300,000 in Wyoming assets pay two-tenths of one mill ($.0002) on those assets, if that is more than $60. For example, $1,210,000 in Wyoming assets produces $242.
Step 3: Apply for the Department of Health License
W.S. 35-2-902 prohibits anyone from establishing a health care facility without a license. Under W.S. 35-2-904(g), the fee for a home health agency is $150. The license year runs July 1 to June 30, and the full fee is due even if you open partway through the year. If you apply today, the current license year ends June 30, 2027, and you pay the full $150.
Licenses are not transferable (W.S. 35-2-904(b) and (e)). If you sell the business, the buyer must obtain its own license. If you change the agency's name, location or number of beds, you need a revised license, which costs $250 under W.S. 35-2-904(h).
Violations are a misdemeanor under W.S. 35-2-909, with penalties of up to $750 and 6 months. Each calendar week of operation without a license counts as a separate offense, so delay is expensive.
Step 4: Plan Medicare and Medicaid Separately
A Department of Health license does not make you a Medicare or Medicaid provider. Medicare certification runs through CMS, and Medicaid enrollment runs through Wyoming Medicaid. Each is a separate process with its own requirements and timeline. Check both before you schedule admissions or promise a start date to a referral source.
Step 5: Get Local Licenses and Permits
Wyoming has no general statewide business license. Only cities and towns can issue business licenses, and counties issue none. Counties handle land use, building, septic and liquor matters. The Secretary of State directs applicants to the city clerk's office in the city where they will operate, so call that office before you sign a lease. Ask whether your use is allowed in the zone and whether any additional permit applies to your business type.
Step 6: Register for Sales Tax Only If You Make Taxable Sales
Sales tax applies to goods and to a short list of enumerated services, including meals, lodging, admissions, telecom, utilities, alcohol, repair and alteration of personal property. If your agency sells any taxable item, you need a sales and use tax license from the Wyoming Department of Revenue, Excise Tax Division. The license carries a $60 non-refundable application fee. Whether a given sale is taxable is a question for the Department and your CPA.
The state sales tax rate is 4%. County option taxes and resort district taxes can sit on top, and there is no city sales tax. County rates change quarterly, so check the Department's rate chart at excise-tax-div.wyo.gov before you quote a rate. Figures in this guide are dated October 2026. Wyoming issues no resale certificate. When you buy inventory for resale, you give your supplier a signed certificate instead.
Step 7: Set Up Workers' Compensation
Workers' compensation in Wyoming is a monopolistic state fund run by the Department of Workforce Services. Ambulatory health care (industry code 621), nursing and residential care (623) and social assistance (6241 to 6243) are compulsory, so your employees fall under the state fund. Sole proprietors, partners, officers and LLC members are excluded unless they elect coverage. Confirm your classification with the Department before your first payroll.
Wyoming Facility Fee Table (W.S. 35-2-904(g))
The table below lists every fee the statute sets for the facility types covered in this guide. Fees for other facility types are not included here, so confirm them with the Department of Health before you apply.
| Facility type | License fee |
|---|---|
| Home health agency | $150 |
| Hospice | $250 |
| Adult day care | $250 |
| Adult foster care home | $250 |
| Assisted living, 1 to 25 beds | $250 |
| Assisted living, 26 to 50 beds | $500 |
| Assisted living, more than 50 beds | $1,000 |
| Nursing care facility | Same tiers as assisted living |
| Boarding home | $500 to $750 (confirm the applicable amount with the Department) |
| Birthing center, ambulatory surgical center, rehabilitation facility, renal dialysis center, freestanding diagnostic testing center or freestanding emergency center | $500 |
| Hospital | $1,000 |
| Revised license after a change of name, location or beds (904(h)) | $250 |
The 2026 Certificate-of-Need Repeal: What Enrolled Act 49 Changed
Enrolled Act 49 (2025 HB0289) takes effect July 1, 2026. It repeals the bed-expansion limits for nursing care facilities and hospitals. It also lets the Department approve alterations or additions to facilities for health and life safety compliance. If older guides describe bed limits for nursing care facilities or hospitals as current law, they are out of date.
The repeal is aimed at nursing care facilities and hospitals. Home health agencies do not operate beds, so the bed-expansion change does not address your license. The $150 fee and the license year are unaffected by this act. Ask the Department to confirm in writing how the act applies to your specific plans.
Common Mistakes to Avoid
- Assuming a formation filing is a health license. The Secretary of State registers your entity. The Department of Health licenses your agency. You need both.
- Using a PO box as your registered agent address. A physical Wyoming street address is required, and a PO box can only be added to it.
- Missing the annual report. A $60 report left unfiled for more than 60 days after the due date can lead to administrative dissolution.
- Opening before the license is in hand. Each calendar week of unlicensed operation is a separate offense.
- Expecting a license to transfer. Licenses are not transferable, so a buyer starts its own application.
- Skipping the city clerk. Wyoming's state license does not replace local business licenses or zoning approval.
- Quoting sales tax from memory. County rates change quarterly, so date every rate and check the Department's chart.
- Waiting on an expedited filing that does not apply. Expedited processing is not available for filings that can be completed online, including initial formations and annual reports.
Tips for a Smoother Launch
- Get the Department's written answer on whether your services need a license before you buy insurance or sign a lease.
- File your entity first, then apply for the health license, so your application reflects your legal name.
- Start Medicare and Medicaid paperwork in parallel with the state license so payer timelines do not hold up your opening.
- Budget for the annual report, registered agent fees and the June 30 license renewal from day one.
- Talk with the Wyoming SBDC Network at wyomingsbdc.org or review SBA resources for Wyoming at sba.gov for planning help.
Expected Results
A complete, accurate filing with the Secretary of State can become active the same day when you file online. Paper filings can take up to 15 business days. Department of Health timing depends on the Department's review, and this guide does not promise a specific turnaround.
Owners who prepare their documents in advance, confirm their license category in writing and separate the state, local and payer steps may find the launch process more predictable. A well-run agency may be able to support patient care and steady operations, but no license or filing guarantees clinical outcomes, referral volume or revenue. Those depend on your staffing, your services and your local market.
Final Checklist
- Confirm in writing whether your services need the Department of Health home health license.
- Choose a name, check it on WyoBiz and reserve it on paper if needed.
- File Articles of Organization or Articles of Incorporation for $100.
- Appoint a registered agent with a physical Wyoming address.
- Apply for the $150 home health agency license and calendar the June 30 license year.
- Contact the city clerk for local licenses and confirm zoning.
- Register for a sales and use tax license only if you make taxable sales.
- Set up workers' compensation with the Department of Workforce Services.
- Start Medicare and Medicaid enrollment with CMS and Wyoming Medicaid.
- Calendar your annual report due date each year.
This article is informational only and is not legal, tax or medical advice. Wyoming statutes, fees and agency practices change. Confirm every figure with the named agency before you rely on it, and consult a qualified Wyoming attorney and CPA for your situation.