How Much Does Texas HHS Pay Family Caregivers? (2026 Guide)

If you're already caring for a parent or loved one every day, Texas has programs that can pay you for that work. The most common question we hear at Rahma Home Care Agency is simple: how much?

Here are the real numbers for 2026, and how to actually get set up.

The Short Answer

As of September 1, 2025, the Texas Legislature raised the base wage for community attendants to an average of $13.00 per hour — up from $10.60. That average is built into what Medicaid pays agencies, so it's the anchor for what attendants (including paid family caregivers) earn across programs like Primary Home Care (PHC), Community Attendant Services (CAS), and STAR+PLUS.

What that means in practice:

Through an agency, family caregivers typically earn at or around the $13/hour average, depending on the agency's pay structure.
Through the Consumer Directed Services (CDS) option, the care recipient acts as the employer and sets the wage within the program's authorized budget — which can allow somewhat higher hourly pay, commonly in the roughly $13–$16 range depending on the program and health plan.

At 20–50 authorized hours per week, that works out to roughly $1,100–$2,800 per month before taxes. Programs like PHC and CAS can authorize up to 50 hours per week based on assessed need.

Which Texas Programs Pay Family Caregivers?

Several pathways lead to a paycheck, and they differ mainly by the care recipient's Medicaid status:

1. Primary Home Care (PHC) — for loved ones with full Medicaid. No waiting list. Eligibility details here.

2. Community Attendant Services (CAS) — for loved ones whose income is too high for regular Medicaid (up to about $2,982/month in 2026). No waiting list. Who qualifies.

3. STAR+PLUS — most adult Medicaid members in Texas get attendant services through their STAR+PLUS health plan, with the same family-hiring options. How STAR+PLUS home care works.

4. Community First Choice (CFC) — a Medicaid entitlement adding attendant and habilitation services for people who need an institutional level of care.

5. Family Care (FC) — for those who don't qualify for any Medicaid program; has a waiting list. Program explained.

Which Family Members Can Be Paid?

Texas is more generous here than many states:

Can usually be paid: adult children, siblings, parents of adult children, grandchildren, nieces/nephews, other relatives, and friends.
Cannot be paid: spouses (in these Medicaid programs), and a parent caring for their own minor child under CAS. Under CDS, the person managing the budget as employer also can't pay themselves.

Every paid caregiver passes a background check, and the tasks a caregiver is paid for must be part of the authorized care plan.

Agency vs. CDS: Two Ways to Get Paid

Agency option. The family member applies to work for a licensed home care agency (like Rahma), which employs them, handles payroll and taxes, provides training, and supervises the care plan. Simplest to set up — the paperwork lands on us, not on you.

Consumer Directed Services (CDS). The care recipient (or their representative) becomes the employer: they hire, schedule, and set the wage, with a Financial Management Services Agency handling payroll. More control and potentially higher pay, but more responsibility.

Many families start with the agency option and consider CDS later. We're happy to explain both honestly — call us at (945) 286-4004.

How to Start, Step by Step

Check the care recipient's status: on Medicaid → PHC or STAR+PLUS; income under ~$2,982/month but no Medicaid → CAS; neither → Family Care.
Call Texas HHS intake at 888-241-1570 (or 2-1-1) to apply. Already on STAR+PLUS? Call the health plan's service coordinator instead.
Complete the home assessment (and doctor's statement where required).
Choose your agency — and tell them you want a family member hired as the attendant.
Start getting paid for care you were already providing.

A Few Honest Caveats

The $13/hour figure is a state-mandated average built into agency reimbursement — individual wages vary by agency and program.
Rates were raised in 2023 and again in 2025, and advocates are pushing for $15+; figures in this article are current as of 2026.
Wages are taxable income, with normal payroll withholding.

We'll Help You Figure It Out

Rahma Home Care Agency serves Dallas, Fort Worth, Arlington, Plano, and surrounding North Texas communities. One phone call and we can usually tell you which program fits, what you'd likely earn, and what the next step is.

Call (945) 286-4004 — free consultation, no pressure.

Rates and limits current as of 2026 and subject to change by the Texas Legislature and HHS. Official sources: hhs.texas.gov.