EVV for Home Health vs. Personal Care: Different Rules
The Cures Act set EVV deadlines of January 1, 2020 for Medicaid personal care and January 1, 2023 for home health. What differs, what is the same, and who is covered.
By Caregiver Scheduling Team ·
The 21st Century Cures Act requires EVV for two kinds of Medicaid services on two timelines. Personal care services (PCS) had to be on EVV by January 1, 2020, with good-faith exemptions through 2020. Home health care services (HHCS) followed on January 1, 2023, with exemptions through 2023. The six data elements are identical. What differs is the service definitions, the agencies affected and the penalty schedule the state faces.
What are the two EVV deadlines?
January 1, 2020 for personal care and January 1, 2023 for home health, both written into section 1903(l) of the Social Security Act (42 U.S.C. 1396b(l)). Congress moved the PCS date back a year from 2019 in Public Law 115-222, signed July 30, 2018. States that showed a good-faith effort and unavoidable system delays could skip the penalty for the first year.
| Topic | Personal care services | Home health care services |
|---|---|---|
| Federal deadline | January 1, 2020 | January 1, 2023 |
| Good-faith exemption | Calendar quarters in 2020 | Calendar quarters in 2023 |
| States and territories granted an exemption | 51 | 44 |
| Federal match reduction if non-compliant | 0.25 points in 2020, 0.5 in 2021, 0.75 in 2022, 1 point from 2023 | 0.25 points in 2023 and 2024, 0.5 in 2025, 0.75 in 2026, 1 point from 2027 |
| Medicaid authority | State plan PCS (1905(a)(24)); 1915(c), (i), (j), (k); 1115 waivers | State plan home health (1905(a)(7)) and waivers |
| Typical providers | Non-medical home care agencies, consumer-directed programs | Medicare-certified home health agencies |
| Typical services | Bathing, dressing, toileting, homemaker, attendant care | Nursing, home health aide and therapy visits |
The exemption counts come from CMS’s trackers for personal care and home health. Nearly every state asked for more time on PCS. The penalty falls on the state’s federal match, not on the agency, but states pass the pressure down through claim edits.
Which services count as personal care, and which as home health?
The statute defines each by its Medicaid authority, not by who performs it. Personal care services are those furnished under the state plan or a waiver, including 1915(c), (i), (j) and (k) programs and 1115 demonstrations. Home health care services are the services described in section 1905(a)(7), meaning nursing, home health aide and therapy visits. CMS’s EVV guidance page lists both.
Two practical results:
- A non-medical agency billing a 1915(c) waiver for attendant care is doing PCS and has been under EVV since 2020 or 2021.
- A certified home health agency billing Medicaid skilled nursing visits is doing HHCS and has been under EVV since 2023 or 2024.
Only services that require an in-home visit by a provider are covered. Services delivered in a day center or clinic are not.
Are the six data elements the same for both?
Yes. The law requires the EVV system to verify the same six facts for every covered visit: the type of service, the individual receiving it, the date, the location, the individual providing it, and the time the service begins and ends. States can require more, and many add a service code or an attestation, but the federal floor is identical. See EVV required data elements.
What does this mean for a home care agency?
If you provide Medicaid personal care, you have been under EVV for years and the open question is only which system your state accepts. If you also run a home health line, both service types need EVV and may use different state aggregators or vendors. Check both in the EVV state directory.
What EVV does not cover:
- Private pay. No federal mandate, although a GPS-verified visit record is still the best proof for a family invoice. See does EVV apply to private pay?
- Medicare home health. The Cures Act mandate is a Medicaid provision. Medicare has its own documentation rules.
- Live-in caregivers. States may exempt them from EVV. See EVV live-in exemption.
Missed or incomplete EVV records become denied claims. See EVV claim denials for the usual causes.
How Caregiver Scheduling handles this
Every visit is checked in and out with a geofenced GPS check that captures the six Cures Act data elements, for Medicaid and private-pay clients alike. On Growth and up, authorization caps per client keep PCS hours inside what the state approved, and visit records export for state EVV aggregators. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
Does Medicare require EVV? No. The Cures Act EVV mandate applies to Medicaid personal care and home health services, not Medicare.
Why did personal care get an earlier deadline than home health? Congress sequenced them that way in section 12006 of the Cures Act. PCS was due in 2019, moved to 2020 by Public Law 115-222, and HHCS was set for 2023.
Are the six data points the same for both? Yes. Service type, individual receiving the service, date, location, individual providing the service, and start and end time.
What happens to a state that still isn’t compliant? Its federal Medicaid match drops by up to 1 percentage point per year under section 1903(l). States pass that pressure on through claim edits and provider requirements.
This article is general information, not legal advice. Check your state Medicaid agency’s EVV rules.