Electronic Visit Verification (EVV) is now federally required for home care agencies billing Medicaid. Here's what you need to know.
What Is EVV?
EVV electronically verifies home care visits by capturing: - Who provided the service (caregiver identity) - What service was provided (type of care) - When the service began and ended (date and time) - Where the service was provided (location via GPS) - Who received the service (client identity)
Federal EVV Mandate
The 21st Century Cures Act (2016) requires EVV for: - Personal Care Services (PCS) — mandatory since January 1, 2021 - Home Health Care Services (HHCS) — mandatory since January 1, 2023
States that don't comply face a phased reduction in federal Medicaid matching funds.
State Implementation
Every state has chosen its own EVV approach:
Open Model States
Providers choose their own EVV system, as long as it meets state requirements and can transmit data to the state aggregator. Examples: Texas, Florida, Ohio.
Closed Model States
The state mandates a specific EVV vendor that all providers must use. Less flexibility but simpler compliance.
Hybrid Model States
The state provides a free system but allows providers to use alternative compliant systems.
Choosing an EVV System
Key Features to Look For
- GPS verification — confirms caregiver location at client's home
- Mobile app — easy for caregivers to use on smartphones
- Telephony option — for caregivers without smartphones
- Real-time monitoring — alerts for late arrivals, missed visits
- Integration — connects with your scheduling and billing software
- Reporting — generates compliance reports for state submission
Popular EVV Systems
- Sandata
- HHAeXchange
- ClearCare/WellSky
- Netsmart
- MEDsys
Cost
- $2–$8 per caregiver per month (typical)
- Some states provide free systems
- Enterprise solutions may charge per visit
Implementation Best Practices
- Start early — don't wait for enforcement deadlines
- Train caregivers thoroughly — hands-on practice, not just a manual
- Have backup methods — telephony for smartphone issues
- Monitor compliance daily — catch missed punches immediately
- Audit regularly — compare EVV data to billing claims
Common EVV Challenges
- Caregiver resistance — "I don't want to be tracked"
- Technology issues — poor cell service, dead phones
- GPS accuracy — signals can be imprecise indoors
- Data discrepancies — EVV times vs. authorized hours
Solutions
- Frame EVV as caregiver protection, not surveillance
- Provide telephony as backup
- Allow reasonable GPS tolerance
- Establish clear policies for discrepancy resolution
Get EVV Help
Information is for educational purposes. Verify your state's EVV requirements.