How Do You Choose EVV Software for a Small Home Care Agency?
Start with your state's EVV model. Then compare caregiver experience, exception handling, aggregator connection and whether EVV feeds payroll.
By Caregiver Scheduling Team ·
Start with your state, not vendors. If your state mandates one EVV system, you will use it for Medicaid visits, and the real question is whether your scheduling software works alongside it. If your state allows provider choice, pick a system that sends the data your state requires, including the six federal data points, to the state aggregator and runs your scheduling, timesheets and payroll, so caregivers check in once. This is a set of criteria, not a ranking.
Disclosure: we make Caregiver Scheduling, which includes geofenced GPS check-in.
What does federal law actually require?
Six data points per visit, verified electronically, but no particular system. The 21st Century Cures Act added 42 U.S.C. 1396b(l), which requires states to use EVV for Medicaid personal care and home health services or lose a share of federal matching funds. The system must verify the type of service, the person receiving it, the date, the location, the person providing it, and the start and end times. The Cures Act says it cannot be read to require “a particular or uniform” system, though CMS says a state can still choose to mandate one. CMS’s EVV guidance page lists the deadlines: January 1, 2020 for personal care and January 1, 2023 for home health, with FMAP reductions up to 1% for states that don’t comply.
Which EVV model is your state using?
Find this out first. It determines how much choice you have. CMS’s May 2018 bulletin describes five models.
| CMS model | What you choose | What to check |
|---|---|---|
| State mandated in-house system or external vendor | Nothing for Medicaid EVV | Does your scheduling software coexist with it, or do caregivers clock in twice? |
| Provider choice | Any system that meets state specs and connects to the aggregator | Is the vendor approved or certified in your state? |
| Managed care plan choice | Possibly a different system per plan | How many apps will caregivers juggle? |
| Open choice | State system or an approved alternative | What the alternative costs and who supports it |
Colorado is an example of open choice. Its EVV FAQ describes a state system plus provider choice systems that connect to the aggregator. Look up yours in the EVV state directory and read open vs. closed EVV models.
What criteria matter most for a small agency?
Caregiver experience and exception handling. They decide whether EVV is a five-second habit or a daily argument.
| Criterion | Ask the vendor |
|---|---|
| Caregiver experience | How many taps to check in? Does it work on older Android phones and iPhones? |
| GPS method | Geofence around the client’s address, or free-form location? What radius? |
| No-smartphone option | Telephony (IVR) from the client’s landline, or a fixed device? |
| Exception handling | What happens when GPS fails or the caregiver forgets? Can the office review and fix with a reason code? |
| Aggregator connection | Is it approved in my state? Who fixes rejected visits? |
| One check-in for everything | Does the same check-in feed timesheets, payroll and invoices? |
| Private-pay clients | Same process for non-Medicaid visits, or a separate workflow? |
| Authorization limits | Does it warn or block visits past authorized units? |
| Cost | EVV included, or a per-visit fee on top? |
Geofenced GPS check-in, where the app checks that the caregiver is within a set distance of the client’s home, is one simple approach. Its weakness is rural addresses and apartment buildings where GPS drifts, so the exception workflow matters as much as the check-in. See when GPS check-in doesn’t work and EVV exception codes.
How should you run a trial?
With real caregivers on real visits for a week, including your least phone-comfortable caregiver.
- Pick two or three caregivers and five to ten clients, Medicaid and private pay.
- Count exceptions each day: missed check-outs, GPS failures, wrong client.
- Time how long the office spends resolving them.
- Export the week to a timesheet and compare it with your current process.
- Ask the vendor to show one rejected visit at the aggregator and how it gets fixed.
If exceptions stay high after a week, the problem is the app, the training or the geofence radius. Find out which first.
What does EVV software cost?
Some states provide a system at no charge. Third-party systems are priced per visit, per caregiver or as part of a scheduling plan. For a small agency, EVV built into scheduling software removes the double check-in, but compare its cost with your state’s free system if it has one, and it removes the double check-in. Compare total cost with home care software pricing.
What are the mistakes small agencies make?
Buying a separate EVV product when the state already provides one, and buying before confirming aggregator approval. Also:
- Choosing on price without a caregiver trial.
- Ignoring private-pay visits and ending up with two processes.
- Assuming the vendor handles aggregator rejections. Ask. See third-party EVV aggregators.
How Caregiver Scheduling handles this
Geofenced check-in and check-out capture the six EVV data points, with override reasons the office sees when GPS can’t confirm. On Growth, authorization caps can stop visits past the limit. Timesheets, payroll export and invoicing are coming soon. Check your state’s model to see whether you also submit through a state aggregator. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
Is EVV software required? For most in-home Medicaid personal care and home health visits, yes, through your state’s system or an approved alternative. Federal rules exclude live-in caregivers, though a state may still choose to require it. Private-pay visits are not covered by the federal rule.
Can I use one app for EVV and scheduling? In states that allow provider choice, often yes. In state-mandated states, Medicaid EVV goes through the state system.
Do caregivers need smartphones? Not always. Many systems offer telephony from the client’s landline or a fixed device. See EVV without a smartphone.
This article is general information, not legal advice. Check your state’s EVV rules.