Home health aide (HHA) training
How to become a home health aide: the federal training rules every state starts from, how the job compares to CNA and personal care aide, pay in every state, and step-by-step state guides with approved program lists.
Compare
Three caregiver jobs that look alike but differ in training, setting, and pay.
| Home health aide | CNA | |
|---|---|---|
| Where you work | Clients’ homes, through home health and hospice agencies | Nursing homes and hospitals |
| Federal training minimum | 75 hours, 16 hands-on | 75 hours, 16 hands-on |
| How you’re listed | Varies by state: certification, a registry, or agency records | Your state’s nurse aide registry |
| Yearly training | 12 hours of in-service | 12 hours of in-service |
| U.S. median pay | $17.21 an hour* | $20.32 an hour |
What does the job involve? See what a home health aide does: duties, the 13 required skills, and how nurses supervise aides. And personal care aides? They focus on daily living help, like meals, housekeeping, and companionship, and usually need less training than home health aides. *Federal pay data counts home health aides and personal care aides together.
Federal rules
Medicare and Medicaid home health agencies must follow these rules, and most states build on them.
Training
75
Competency
RN
On the job
12/yr
State guides
Each state guide covers its own hours, certification, costs, renewal, and every approved training program.
Pay
Median pay for home health and personal care aides in every state, highest first, from the federal May 2025 wage survey.
| State | Median hourly | Median yearly | Workers | |
|---|---|---|---|---|
| Washington | $22.95 | $47,730 | 103,260 | |
| Oregon | $21.35 | $44,410 | 42,330 | |
| Rhode Island | $21.00 | $43,680 | 7,490 | |
| District of Columbia | $20.53 | $42,700 | 12,810 | |
| Vermont | $20.00 | $41,600 | 7,700 | |
| Massachusetts | $19.67 | $40,910 | 117,940 | |
| Alaska | $19.11 | $39,740 | 6,530 | |
| New York | $19.05 | $39,620 | 663,140 | |
| North Dakota | $18.96 | $39,440 | 7,730 | |
| Connecticut | $18.75 | $38,990 | 49,510 | |
| New Hampshire | $18.64 | $38,760 | 9,440 | |
| Maine | $18.55 | $38,580 | 18,630 | |
| Colorado | $18.53 | $38,540 | 44,650 | |
| Minnesota | $18.45 | $38,370 | 128,680 | |
| Hawaii | $18.32 | $38,110 | 6,150 | |
| Illinois | $18.30 | $38,060 | 134,100 | |
| Maryland | $18.29 | $38,040 | 46,560 | |
| South Dakota | $18.15 | $37,740 | 4,210 | |
| New Jersey | $17.83 | $37,090 | 117,080 | |
| Montana | $17.61 | $36,630 | 10,400 | |
| Kentucky | $17.52 | $36,440 | 31,260 | |
| Arizona | $17.51 | $36,420 | 74,540 | |
| Wisconsin | $17.47 | $36,340 | 82,430 | |
| Nebraska | $17.38 | $36,150 | 13,660 | |
| Iowa | $17.34 | $36,080 | 25,800 | |
| Utah | $17.25 | $35,880 | 17,130 | |
| Indiana | $16.86 | $35,060 | 57,050 | |
| Michigan | $16.83 | $35,000 | 95,020 | |
| Idaho | $16.72 | $34,790 | 20,770 | |
| Ohio | $16.57 | $34,460 | 106,940 | |
| California | $16.50 | $34,320 | 970,150 | |
| Delaware | $16.50 | $34,320 | 11,820 | |
| Florida | $16.25 | $33,800 | 90,170 | |
| Nevada | $16.19 | $33,670 | 17,940 | |
| Wyoming | $15.96 | $33,190 | 3,410 | |
| Missouri | $15.90 | $33,080 | 94,810 | |
| Tennessee | $15.45 | $32,130 | 35,950 | |
| Kansas | $15.03 | $31,260 | 25,350 | |
| North Carolina | $15.02 | $31,240 | 58,880 | |
| Virginia | $14.57 | $30,300 | 70,070 | |
| South Carolina | $14.48 | $30,110 | 40,750 | |
| Pennsylvania | $14.14 | $29,420 | 257,370 | |
| Georgia | $14.07 | $29,270 | 50,870 | |
| New Mexico | $13.71 | $28,520 | 38,910 | |
| West Virginia | $13.47 | $28,010 | 18,890 | |
| Alabama | $13.39 | $27,840 | 20,930 | |
| Oklahoma | $13.32 | $27,710 | 20,310 | |
| Arkansas | $13.30 | $27,660 | 19,840 | |
| Texas | $11.65 | $24,230 | 329,590 | |
| Mississippi | $11.47 | $23,860 | 21,800 | |
| Louisiana | $10.83 | $22,520 | 45,060 |
CNAs usually earn more: the U.S. median for CNAs is $20.32 an hour. Many aides hold both credentials. See CNA pay by state.
FAQ
Short answers to what people ask most.
A home health aide (HHA) helps clients at home with personal care, like bathing, dressing, moving around, and basic health checks, under the supervision of a nurse from a home health or hospice agency.
At least 75 hours under federal rules for Medicare and Medicaid home health agencies, including at least 16 hours of supervised practical training. Some states require more, like California's 120-hour program for non-CNAs.
No. CNAs are trained for nursing homes and hospitals and listed on a state nurse aide registry. Home health aides work in clients' homes through home health agencies. Many states offer a shorter route to home health aide for people who are already CNAs.
Personal care aides mostly help with daily living, like housekeeping, meals, and companionship, and usually need less training. Home health aides can also do basic health-related tasks under a nurse's supervision.
Federal rules require at least 12 hours of in-service training every 12 months for aides working for Medicare and Medicaid home health agencies. Some states add their own renewal requirements.
Under federal rules, if you go 24 months in a row without paid home health aide work, you have to complete a new training program before working for a Medicare or Medicaid home health agency again.