Search for what a home health agency is worth and you find two kinds of pages. Advisors who sell their services publish ranges of multiples. Listing sites publish asking prices. Neither is a record of what agencies sold for.
This article quotes both, dated and labelled for what they are. Then it covers what drives the figures the advisors name, and which of those drivers you can see in Medicare's own data. Logicly does not put a value on any agency, and nothing on this page is our estimate of one.
A note on labels. An advisor's range is labelled the advisor's marketing and quoted from its page, with the date the page says it was updated and the day I read it. A listing price is labelled an asking price, not a sale. A rule is a federal regulation, cited by paragraph. The moratorium notice is CMS's own notice in the Federal Register, quoted. Advice marked as our suggestion is ours, not a rule.
Warning
This is not financial, legal or tax advice. Before you price or buy an agency, use an advisor, a healthcare attorney and an accountant you hire for the deal.
The Short Answer
- There is no list price. An agency is worth what a buyer pays for it.
- Advisors quote earnings multiples. Ad Astra says a home health agency "typically sells for 5x–12x adjusted EBITDA" (page updated June 5, 2026, read October 26, 2026), and other advisors' bands differ. That is their marketing, not a record of sales.
- Listings show asking prices. The four California listings below ask from $57,500 for a state license only to $449,000 for a certified agency with seven patients. Those are asking prices, not sales.
- What the advisors say drives the figure: Medicare certification, payer mix, census, star rating and staff.
- What you can check yourself: the star ratings on the free agency profile, and Medicare payment, patients and payer share of visits in the paid report, from Medicare data for 2024.
Two Terms First
Advisors price agencies as a multiple of earnings, and they use two measures of earnings.
- EBITDA is earnings before interest, taxes, depreciation and amortization. "Adjusted EBITDA" is EBITDA after the add-backs the seller argues for.
- SDE is seller's discretionary earnings. Ad Astra's valuation guide (updated June 12, 2026, read October 26, 2026), citing "the IBBA/M&A Source Market Pulse framing", explains when each is used: businesses "valued under ~$2M are priced on SDE (which adds back the owner's full compensation); those at $2M and above are priced on adjusted EBITDA (which subtracts a market-rate replacement manager)."
So "4x SDE" and "4x EBITDA" are different prices for the same agency. Check which one a range uses before you compare it with anything.
What Advisors Say, in Their Own Words
All of the ranges below are the advisor's marketing. Each page sells advisory services. I read each one on October 26, 2026.
Ad Astra
From "Home Health Agency EBITDA Multiples & Valuation (2026)", updated June 5, 2026:
A home health agency typically sells for 5x–12x adjusted EBITDA, but the band you land in depends almost entirely on a single binary question: are you Medicare-certified?
The same page: "Non-medical / private-duty personal-care agencies clear 3–5x EBITDA (or roughly 2–3.5x SDE for owner-run shops). Medicare-certified skilled home health regional multi-branch agencies ($5–25M revenue) clear 6–9x."
The page also offers a slider estimate, and calls it "a planning estimate, not a formal valuation."
CT Acquisitions
From its New Hampshire page, "Sell Your Home Health Agency in New Hampshire (2026)", updated October 5, 2026, under "Home-Health (Medicare-certified) multiples by EBITDA band":
Sub-$2M EBITDA owner-operator (SDE basis): 3.0x to 6.0x SDE. Median ~4.0x for single-branch, owner-dependent.
$2-5M EBITDA mid-market regional: 6.0x to 8.0x EBITDA. Median ~7.0x with diversified payer mix, 4+ star rating, enterprise EMR.
A law firm's view
Arnall Golden Gregory, a law firm, wrote on JD Supra on May 1, 2026 that "Valuation is increasingly tied to verifiable performance, including compliance posture, revenue reliability, and technology infrastructure, rather than adjusted EBITDA narratives." It also says buyers "reduced tolerance for EBITDA add-backs, with adjustments moving from approximately 20% of EBITDA to a more constrained range of 12% to 15%." That is a law firm's view of the market, not a record of sales.
The two advisors' bands do not line up. Ad Astra's 6–9x is for certified agencies with $5 million to $25 million in revenue. CT Acquisitions' 6.0x to 8.0x is for $2 million to $5 million in EBITDA. One band is set by revenue and the other by earnings, so they cannot be compared directly. Read each range as that advisor's view.
What Agencies Are Listed For
These are asking prices, not sales. All four are California listings on BizBen, read October 26, 2026. The descriptions are the sellers' words.
| Listing | Asking price | What the listing says |
|---|---|---|
| San Diego County Home Health Agency, 36-Month Exempt, Staffed | $400,000 | "Medicare and Medicaid certified, ACHC accredited, California state licensed"; "Census of 19 (seller reported)" |
| Sacramento Home Health Agency - Medicare Certified, No 36-Month Rule! | $449,000 | "Active census of 7 patients, generating a projected $225K in 2025 revenue." |
| Provisional License Home Health Agency - Clean Slate in SoCal | $125,000 | "Holds a Provisional License ONLY. State Certified and ACHC Accredited. Zero census and zero staff." |
| California Home Healthcare Business for Sale in Santa Ana | $57,500 | "State License Only. Buyer would need to apply for Medicare, and must pass the second survey before they can operate." |
The San Diego listing says plainly what is being sold: "New Medicare home health enrollment is frozen nationwide, so an already-enrolled agency is one of the few ways into an operating provider number." And: "Most of the value is the certified provider number and its reach, not current cash flow."
Two of the four say the 36-month rule does not apply. Those are the sellers' claims. Check them yourself; our guide to buying a home health agency shows how.
Why Certification Matters More in 2026
As of October 26, 2026, Medicare is not enrolling new home health agencies. CMS's notice (FR Doc. 2026-09717) says: "This moratorium is effective May 13, 2026." And: "no new HHAs or HHA branches or practice locations will be enrolled into Medicare unless the HHA's enrollment application was received by the applicable Medicare contractor prior to this notice's effective date."
It "remains in effect for 6 months. If CMS deems it necessary, the moratorium may be extended in 6-month increments." Six months from May 13, 2026 is November 13, 2026. That date is our arithmetic, not a date CMS published. As of October 26, 2026, CMS had published no extension.
So a licensed-only agency, like the Santa Ana listing, cannot get into Medicare while the moratorium lasts, unless the Medicare contractor received its application before May 13, 2026. A certified agency already enrolled is different. Apart from "their ability to add branches to their enrollments", CMS says "the moratorium would not impact the roughly 11,500 currently enrolled HHAs, which could continue furnishing services (assuming they remain compliant with all Medicare requirements)."
Buying one is a change of ownership. Citing § 424.570(a)(1)(iii), the notice says the moratorium does not apply to "Changes in ownership (except changes in ownership of HHAs, hospices, and suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that would require an initial enrollment)." (FR Doc. 2026-09717, section c.) The exception is the 36-month rule. Under 42 CFR 424.550(b)(1), a change in majority ownership within 36 months after the effective date of the agency's initial enrollment, or within 36 months after its most recent change in majority ownership, means "the provider agreement and Medicare billing privileges do not convey to the new owner", unless an exception in paragraph (b)(2) applies. The notice says that in these sales "The HHA's current enrollment and provider agreement are terminated", and that re-enrolling "would constitute an initial enrollment", which the moratorium blocks. Deals differ, so have a healthcare attorney confirm it for yours.
What Drives the Figures Advisors Name
The advisors name the same handful of drivers. Here they are in the advisors' words, which are their marketing too, all from Ad Astra's page updated June 5, 2026 and read October 26, 2026, with what you can check in Medicare's own data.
- Medicare certification. Ad Astra calls it "The single most important fact in home health valuation."
- Medicare revenue and payer mix. Ad Astra calls payer mix "The #1 internal value driver an owner controls."
- Census, the number of patients on service. The listings above name it in their titles and descriptions.
- Star rating. Ad Astra says "4.5–5 star agencies earn a ~+1.5x multiple premium because they de-risk the buyer's regulatory exposure."
- Staff. Ad Astra says "Industry caregiver turnover averages 60–80%; agencies holding sub-50% turnover significantly de-risk post-close operations and command a premium."
| Driver | Free agency profile | Paid report (Medicare data for 2024) |
|---|---|---|
| Medicare certification | The year Care Compare lists as its certification date | Not a separate item |
| Medicare revenue | Not shown | What Medicare paid it, by year, traditional Medicare only |
| Payer mix | Not shown | Who pays, as a share of visits, from its 2024 cost report when it filed one |
| Census | Not shown | Its traditional Medicare patients and 30-day periods, by year |
| Star rating | Both Care Compare star ratings and its quality measures | See the free profile |
| Staff | Not shown | Nursing and therapy staff, employees and contract, from its 2024 cost report. What it pays clinicians per visit, a Logicly estimate |
| Margin | Not shown | A Logicly estimate of its Medicare margin, from its 2024 cost report. Our figure, not a Medicare number |
What neither shows: private-pay revenue, Medicaid rates, Medicare Advantage revenue, payer contracts, the adjusted EBITDA a seller claims, and the findings of the state's inspections. Ask the seller for those.
Our suggestion, not a rule: if an agency sold to you as Medicare-certified has no profile here, ask the seller why. Care Compare is refreshed every few months, so a newly certified agency may not be on it yet.
Buying an agency? Check it before you sign
The 36-month rule, the moratorium, and five checks to run on the agency, with what to ask the seller for.
Frequently Asked Questions
How much is a home health agency worth?
There is no list price. An agency is worth what a buyer pays for it. Advisors quote ranges of earnings multiples instead. Ad Astra, an M&A advisor, says on its page (updated June 5, 2026, read October 26, 2026) that a home health agency "typically sells for 5x–12x adjusted EBITDA". That is the advisor's marketing, not a record of sales. Logicly does not put a value on any agency.
What multiple do home health agencies sell for?
Advisors publish ranges, and they do not agree. Ad Astra (page updated June 5, 2026) says Medicare-certified regional agencies with $5 million to $25 million in revenue "clear 6–9x" adjusted EBITDA. CT Acquisitions (page updated October 5, 2026) puts Medicare-certified owner-operator agencies under $2 million in EBITDA at "3.0x to 6.0x SDE", where SDE is seller's discretionary earnings. Both are the advisors' marketing, read October 26, 2026, not records of what agencies sold for.
Is a Medicare-certified agency worth more than a licensed-only one?
Advisors say so, and the 2026 moratorium is one reason buyers care. CMS's notice says "no new HHAs or HHA branches or practice locations will be enrolled into Medicare unless the HHA's enrollment application was received by the applicable Medicare contractor prior to this notice's effective date." A licensed-only agency whose Medicare application the contractor had not received before May 13, 2026 cannot enroll while the moratorium lasts. A certified agency can still be bought: the notice says the moratorium does not apply to "Changes in ownership (except changes in ownership of HHAs, hospices, and suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that would require an initial enrollment)", which a sale caught by the 36-month rule in 42 CFR 424.550(b) would. Have a healthcare attorney confirm it for your deal. Ad Astra, an advisor, says "Medicare-certified agencies command a 1.5–2x higher multiple than non-certified" (page updated June 5, 2026, read October 26, 2026). That is its marketing, not a record of sales. As of October 26, 2026, CMS had published no extension of the moratorium.
See the agency reports
The full report on one named agency uses Medicare data for 2024, from $79 one time. The sample report shows the county report on invented agencies.
Sources
Advisors and a law firm (their marketing and views, read October 26, 2026):
- Ad Astra, Home Health Agency EBITDA Multiples & Valuation (2026), updated June 5, 2026
- Ad Astra, What Is My Home Health Agency Worth? How Buyers Value It, updated June 12, 2026
- CT Acquisitions, Sell Your Home Health Agency in New Hampshire (2026), updated October 5, 2026
- Arnall Golden Gregory LLP on JD Supra, Home Health & Hospice M&A in 2026: Why the Market Has Reset and What Buyers Want Now, May 1, 2026
Listings (asking prices, not sales, read October 26, 2026):
- BizBen, San Diego County Home Health Agency, 36-Month Exempt, Staffed
- BizBen, Sacramento Home Health Agency - Medicare Certified, No 36-Month Rule!
- BizBen, Provisional License Home Health Agency - Clean Slate in SoCal
- BizBen, California Home Healthcare Business for Sale in Santa Ana
The moratorium and the rule:
- FR Doc. 2026-09717, Announcement of Nationwide Temporary Moratoria on Enrollment of Home Health Agencies, 91 FR 27954, published May 15, 2026. Quoted: the effective date, the scope, the 6-month length; section c, the cases the moratorium does not cover (changes in ownership, citing § 424.570(a)(1)(iii)); the currently enrolled agencies and their branches; and section D on § 424.550(b).
- Federal Register, documents from the Centers for Medicare & Medicaid Services. Searched October 26, 2026 for any extension of the home health moratorium published since May 16, 2026; none found.
- 42 CFR § 424.550, Prohibitions on the sale or transfer of billing privileges (Cornell LII), read October 26, 2026. Relied on: paragraph (b)(1), the 36-month rule, and paragraph (b)(2), its exceptions.
CMS data behind the profile and the report:
- CMS Care Compare, Home Health Care Agencies: the star ratings and certification date on the profile.
- CMS Medicare Post-Acute Care Utilization: Medicare payment and patients in the report, 2024.
- CMS Home Health Agency Cost Report: who pays and the Logicly margin estimate in the report, fiscal year 2024.