2. Massachusetts — $39,700 Median
Massachusetts pays $19.05 an hour at the median, second only to California. Boston metro drives the numbers up, and the state has strong home care worker protections.
The MassHealth Personal Care Attendant program lets consumers hire and manage their own aides. PCAs earn union-negotiated rates that increased $2.50 an hour between 2022 and 2025.
Western Mass pays less but housing costs are also lower. Boston area aides who work weekends and holidays regularly clear $45K to $48K annually before overtime.
