What Is EVV? Electronic Visit Verification for Home Care Agencies
EVV is the federal requirement that Medicaid personal care and home health visits be verified electronically. The six data points, the deadlines, the state models, and what agencies have to do.
By Caregiver Scheduling Team ·
Electronic visit verification (EVV) is a system that records when and where a home care visit happened, electronically, at the time of the visit. Section 12006 of the 21st Century Cures Act requires every state Medicaid program to use EVV for personal care services and home health care services that involve an in-home visit (CMS EVV overview). If your agency bills Medicaid for personal care, your visits have to be verified through EVV or your claims can be denied.
What are the six EVV data points?
Every EVV record must capture:
- Type of service performed
- Individual receiving the service
- Date of the service
- Location where the service was delivered
- Individual providing the service
- Time the service begins and ends
The usual methods are a mobile app with GPS, a phone call from the client’s landline, or a small fixed device in the home. See the six EVV data elements in detail.
Which services need EVV?
| Service | Federal deadline | Covers |
|---|---|---|
| Personal care services (PCS) | January 1, 2020, with good-faith exemptions to 2021 | Medicaid state plan PCS and PCS under 1915(c), (i), (j), (k) and 1115 waivers |
| Home health care services (HHCS) | January 1, 2023, with good-faith exemptions to 2024 | Medicaid home health under the state plan or a waiver |
EVV is a Medicaid requirement. It doesn’t apply to private-pay clients under federal law. See does EVV apply to private pay?
States that don’t comply lose part of their federal Medicaid match, which is why states enforce it on providers.
How states run EVV: the main models
| Model | What it means for your agency |
|---|---|
| State-mandated system | Everyone uses the state’s vendor. You may also need it alongside your own scheduling software |
| Provider choice (“open”) | Use any EVV system that sends data to the state’s aggregator |
| Managed care plan choice | Each plan picks a system, so you may use more than one |
| Hybrid | The state offers its own system but lets providers use an approved alternative |
Your state’s model decides whether you can use your scheduling software’s check-in for EVV or need a second app. Look up your state in the EVV state directory.
Do live-in caregivers need EVV?
CMS allows states to exempt visits where the caregiver lives with the person receiving care, and many states do. Requirements vary, so check your state’s page in the EVV directory.
What agencies have to do
- Find your state’s model and aggregator. This sets which systems you can use.
- Train caregivers on check-in and check-out. Most EVV problems are missed or late punches.
- Decide how exceptions are handled. When GPS fails or a caregiver forgets to clock out, the correction needs a reason code and a supervisor’s approval.
- Reconcile before billing. Compare EVV visits with authorized units before you submit claims.
- Keep records. Store EVV data as long as your state requires for Medicaid records.
How Caregiver Scheduling handles this
Caregivers check in and out in the app with a geofenced GPS check at the client’s home, which records all six data points. When GPS can’t confirm the location, the caregiver gives an override reason and the office sees it for review. On Growth and up, authorized hours are checked as you schedule so visits don’t go over them. Timesheets built automatically from check-ins are coming soon. Check your state’s model in the EVV directory to see whether you also need to submit through a state aggregator. $199/month for up to 10 caregivers or $299/month for up to 50.
FAQ
What does EVV stand for? Electronic visit verification.
Is EVV required for non-medical home care? It’s required for Medicaid-funded personal care, which includes many non-medical services like help with bathing and dressing. It isn’t federally required for private-pay clients.
Can caregivers use their own phones for EVV? Usually yes, through a mobile app. States also accept telephony and fixed devices for caregivers without smartphones.
What happens if a visit isn’t verified? The claim can deny or be held until the visit is corrected with an approved exception.