EVV Requirements by State: A Home Care Agency Map

The federal requirement is identical everywhere: six data points per Medicaid-funded personal care or home health visit. Everything else is a state decision, and that is why an agency crossing a state line finds the same visit accepted in one place and rejected in another. This page is a working map for an agency owner: what varies, where to read the authoritative answer, and which questions to ask a vendor before you agree that they cover your state.

Three models, and which one you are in

States run open models (bring your own vendor, transmit to the state aggregator), closed models (use the state's system) and hybrid models (the state provides a system but you may use your own). Your model decides whether EVV is a purchase or an enrollment. Agencies in Pennsylvania, Ohio, Michigan, Missouri, Colorado, Georgia, Virginia, Indiana and Minnesota each answer this differently, and the answer moves when a state re-lets its aggregator contract.

What actually differs between states

Four things, reliably: which aggregator receives the file, how long you have to correct an exception before the claim is affected, what counts as an acceptable manual entry reason, and which services are in scope beyond the federal minimum. The last one catches agencies out most: some states extend EVV to programs the Cures Act never named, so a service you bill without verification in one state is a rejected claim in the next.

How to check your own state properly

Read the state Medicaid agency's EVV page, not a vendor's summary, and read it again each year. States publish the aggregator, the provider enrollment route, the exception reason codes and the training they require. If your vendor cannot point you at that page and tell you the date they were last certified against it, they are describing their roadmap rather than your compliance.

Running more than one state

Multi-state agencies should expect two of everything until they choose a system that abstracts it: two portals, two exception queues, two reason-code vocabularies. The practical test for a vendor is not whether they claim national coverage but whether one scheduler can work both states' exceptions in a single screen at nine in the morning. Ask to see that screen with real state data in it.

PA EVV and Ohio EVV: one aggregator, two ways in

Both states run on Sandata and the agency experience is still not the same. Pennsylvania's Department of Human Services built its system with Gainwell Technologies and Sandata so that visits land in the PA-DHS EVV Aggregator and integrate with PROMISe, the state's existing Medicaid claims system, and an agency that wants to keep the product it already owns registers that product as an alternate EVV system instead. Ohio lets agency providers and independent providers choose either the state-provided Sandata system or an Ohio certified alternate, and the certification is real work: an alternate has to comply with the technical specifications, adhere to the business rules, complete a technical certification process with Sandata, and then pass a demonstration with the Ohio Department of Medicaid. Ohio also states plainly that neither the department nor Sandata is responsible for any cost of developing, certifying or using that alternate. Read that as the working rule for any state of this shape: the state system is the cheap path and the alternate is a project with a budget.

Michigan EVV and Missouri EVV: two open models that ask different things of you

Michigan runs an open vendor model. MDHHS offers HHAeXchange as the state system, and a provider that already owns an EVV product, or wants to buy one, integrates it with the state's aggregator instead, so long as it meets HHAeXchange's published technical specifications and business requirements. Missouri arrives at something similar from the other end: it operates an EVV Aggregator Solution hosted by Sandata Technologies, personal care and home health providers use an EVV vendor of their own choosing, and the constraint is that the vendor must already have completed testing with Sandata in Missouri and be submitting data to that aggregator. So the question you put to a vendor differs by state. In Michigan it is whether they integrate with HHAeXchange. In Missouri it is whether they are on the state's tested list today, not whether they plan to be.

Georgia EVV and Virginia EVV: one state solution, and a rule that hands you the choice

Georgia's Department of Community Health implemented the state EVV solution, Netsmart Mobile Care+, for personal care services, and is still working out how to extend it to home health care services. The revised home health timeline on the state's own page is a soft go live of August 31, 2026, with all applicable home health claims dated on or after September 14, 2026 required to come through EVV. A provider may instead select a third party solution that is already integrated with the state solution, which is a narrower door than it sounds, because integration has to exist before you sign rather than after. Virginia writes the opposite into the rule itself. 12VAC30-60-65 says agency providers shall choose the EVV system that best suits the provider business model, meets the regulatory requirements of that section, and provides reliable functionality for the geographic area it is to be used in. The same rule tells you how long to hold the data: at least six years from the last date of service, and longer while an audit is open.

Colorado EVV: what a federal audit of EVV Colorado found, and why manual entry is the thing to watch

Colorado's Department of Health Care Policy and Financing publishes its own EVV program manual, and the sharpest published reading of how the program actually runs is the federal audit of it. In report A-07-24-03260, issued on July 17, 2026, the HHS Office of Inspector General found that Colorado had implemented an EVV system but did not verify that all personal care visits were recorded and verified in it, and that the state did not always comply with federal and state requirements when it claimed for those services. It recommended the state refund $8,072,870 as the federal share of estimated overpayments, and work with CMS on a further $45,688,080 the audit set aside; it also asked for system edits governing how often an attendant may use manual entry, and edits that check every visit has a matching EVV record. Colorado disagreed with most of it. The operational lesson travels well past Colorado: manual entry is the number a payer comes back to, so cap it, record a reason against each one, and be able to show the ratio without building a report first.

Questions people ask about evv requirements by state

Is there one national EVV standard we can build to?

There is one federal data standard, the six points, and no national implementation. The Cures Act deliberately left the mechanism to states, so an agency's compliance is always read against its own state Medicaid agency's rules.

Our vendor says they support all fifty states. Is that meaningful?

Only if they can name your aggregator and the date of their last certification against it. Support is a claim about integrations, and integrations expire when a state changes contracts or file formats.

Does EVV apply to Medicare home health visits?

The mandate is Medicaid-funded. Medicare-certified agencies still capture visits electronically for their own documentation and billing, but the EVV requirement itself rides on Medicaid personal care and home health services.

How often do state EVV rules change?

Materially every few years, when an aggregator contract is re-let or a program is added to scope. Put a calendar reminder against your state's EVV page rather than waiting for a rejection to tell you.

EVV requirements by state: the three models and what actually differs