HCS Group Home (IDD)

Medicaid-funded home for 3–4 adults with intellectual disabilities

No ALF License — Medicaid Funded

To open a HCS Group Home (IDD) in Texas, you do not need a state license — you enroll with Texas HHSC. It serves up to 4 residents, and the exact government fees total about $1,090 (No ALF license needed — requires HCS provider contract with HHSC and enrollment with your Local IDD Authority (LIDDA)). Below is every step, fee, and official link.

Reviewed by Erika Crossley, Texas senior care startup specialist · Information last verified June 2026

Path

Standard path

Gov't fees (total)

$1,090

State license

None

Max residents

Who this serves

Adults with intellectual or developmental disabilities (IDD) who qualify for the Texas HCS Medicaid waiver

Best fit: Someone committed to serving the IDD population — Medicaid pays reliably, no ALF license required, small residential setting

Common questions about opening a HCS Group Home in Texas

Do I need a license to open a HCS Group Home in Texas?

No ALF license needed — requires HCS provider contract with HHSC and enrollment with your Local IDD Authority (LIDDA)

How much does it cost to open a HCS Group Home in Texas?

The exact government fees total about $1,090. On top of that, variable startup costs (insurance, any required modifications, and similar) depend on your property and market. Government fees are fixed; variable costs are estimates.

How many residents can a HCS Group Home in Texas have?

1 to 4 residents — an HCS home can have as few as 1; 4 is the program cap

How much can a HCS Group Home earn per resident in Texas?

Roughly $3,000–$8,000 per resident per month, depending on private pay vs. Medicaid, acuity, and your market.

Actual Costs

Government fees are exact. Variable costs are estimates — tips show how to minimize them.

EXACT

Government Fees — You Will Pay These

HHSC HCS Provider Enrollment

No state application fee

one time

Federal Medicaid provider application fee (PEMS)

Required federal institutional provider application fee for CY2026 — $750 (42 CFR §455.460). Set annually by CMS.

$750

one time

Texas LLC Formation (SOS filing)

$300

one time

DPS Background Check

Required for all staff and household members ($11.50 IdentoGO + $15.00 DPS + $13.25 FBI = $39.75)

$39.75

per person

HHSC LIDDA Enrollment

Free — LIDDA manages resident placement

one time

Local business registration

$0–50

annual

Guaranteed minimum (gov't fees)

$1,090

VARIABLE

Costs That Depend on Your Property & Choices

General liability + professional liability insurance

$2,400–$6,000/annual

HCS group home insurance — we connect you with vetted insurers (Markel, GuideOne, Philadelphia Insurance) and pull quotes for you

Home modifications for accessibility

$2,000–$15,000/one time

Grab bars, ramps, wider doorways — depends on residents' specific needs

Staff training (HCS required)

$500–$2,000/annual

HHSC requires specific HCS training — some free online through HHSC portal

Supplies, adaptive equipment

$1,500–$5,000/one time

Per individual service plans — Medicaid often covers specialized equipment

Physical & Building Requirements

Stories allowed

Any

Sq ft / resident (single room)

Residential standard

Sq ft / resident (shared room)

Residential standard

Bedroom min width

No minimum

Bathroom ratio

Adequate per individual resident service plans

Sprinklers

Per local residential building code

•Must have adequate outdoor space (a real backyard) — we confirm this for your address when you submit your home in the roadmap
•Needs full kitchen, bathroom, and adequate storage
•Must meet HCBS Settings Rule: must look and feel like a real home, not an institution
•Fair Housing: the federal Fair Housing Act plus Texas protections strongly protect group homes in residential zoning

Can I Use My Home?

✓

1-Story Home

✓

2-Story Home

1,400

sq ft minimum

bedrooms

→1-story preferred — easier accessibility for residents
→2-story ok with proper safety planning
→Must have a real backyard — we confirm this for your address when you submit your home in the roadmap
→Fair Housing protections (federal Fair Housing Act + Texas protections) strongly protect group homes in residential zoning

Why operators choose this

+Medicaid pays — residents never pay out of pocket
+No ALF license required
+No state enrollment fee (a federal Medicaid application fee — $750 for CY2026 — does apply)
+Strong, stable government reimbursement rates
+Fair Housing protections strongly favor group homes against zoning challenges

Know before you start

–Serves only IDD population — specialized knowledge required
–Hard cap at 4 residents limits total revenue
–Medicaid documentation and compliance requirements
–Getting residents matched through LIDDA can take time

Key Restrictions — Know These Before You Start

!Residents must be IDD-eligible and enrolled in the HCS Medicaid waiver program
!Maximum 4 residents — hard cap built into the HCS program
!Medicaid-funded only — no private pay option in this program model
!Must comply with HCBS Settings Rule (community integration, individual rights)
!Must contract with your Local IDD Authority (LIDDA) for resident placement
!Reimbursement varies by each resident's assessed Level of Need (LON) — the $3,000–$8,000/resident range is LON-dependent

Apply Directly

Every link goes to the exact page — no searching.

We keep these links and fees current — regulations change, so we re-confirm yours when you start.