Everything Medicaid home care and home health agencies need to know about Electronic Visit Verification under the 21st Century Cures Act — including how Open, Closed, and Hybrid vendor models differ across all 50 states.
Electronic Visit Verification (EVV) is a federally-mandated system that electronically records key details of every Medicaid-funded home visit. It was established under Section 12006 of the 21st Century Cures Act, which requires states to implement EVV for personal care services (PCS) and home health care services (HHCS) reimbursed by Medicaid.
For agency owners, EVV is more than a checkbox — it directly affects claim acceptance, reimbursement timelines, and audit exposure. Missing or incomplete EVV data is one of the most common reasons Medicaid claims are denied or delayed.
CMS allows states flexibility in how they implement EVV. Which model your state uses determines whether you can bring your own EVV system.
The state accepts EVV data from any compliant vendor. Agencies choose their own EVV system and transmit visit data to the state aggregator.
The state contracts a single EVV vendor that all providers must use. Agencies typically cannot use an alternative system.
Agencies may use the state-provided EVV system for free or choose an alternate EVV vendor that meets state data specifications.
Managed Care Organizations select and manage EVV systems on behalf of providers, often with data flowing to a state aggregator.
Florida, Texas, and New York represent three of the largest Medicaid home care populations — and three very different EVV approaches.
The Agency for Health Care Administration (AHCA) operates an open model with Tellus as the state aggregator. Providers may use the free state solution or an alternate EVV vendor that transmits compliant data.
Texas HHSC runs a state-mandated model. Providers must use one of a small set of state-approved EVV vendors, with HHAeXchange as the state aggregator for most programs.
New York uses eMedNY as the state aggregator. Managed Long-Term Care plans commonly require HHAeXchange for CDPAP and personal care services.
EVV programs evolve. Always confirm current requirements with your state Medicaid agency and any Managed Care Organization contracts before onboarding.
| State | Model | State Aggregator | Notes |
|---|---|---|---|
| Alabama | Open Vendor | Sandata | Alabama Medicaid uses Sandata as the state aggregator; agencies may choose an alternate compliant EVV vendor. |
| Alaska | Provider Choice | Therap | Alaska operates a provider-choice model with Therap as an approved aggregator. |
| Arizona | Open Vendor | Sandata | AHCCCS uses Sandata for aggregation and allows alternate EVV vendors. |
| Arkansas | Closed / State-Mandated | AuthentiCare | Arkansas requires providers to use the state's contracted EVV system for personal care and home health. |
| California | Provider Choice | CDSS EVV / Sandata | IHSS uses the state's telephonic and mobile EVV. Home Health follows a provider-choice model. |
| Colorado | Provider Choice | Sandata | Colorado HCPF uses Sandata as the aggregator and allows alternate EVV vendors. |
| Connecticut | Closed / State-Mandated | Sandata | Connecticut requires use of the state-contracted Sandata solution for most Medicaid programs. |
| Delaware | Open Vendor | Sandata | Delaware uses Sandata for aggregation; providers may choose an alternate EVV solution. |
| Florida | Open Vendor | Tellus / AHCA | Florida AHCA operates an open model. Agencies may use the state's Tellus solution or an alternate vendor. |
| Georgia | Open Vendor | Netsmart Tellus | Georgia DCH uses Tellus as the state EVV aggregator and permits alternate vendors. |
| Hawaii | Provider Choice | Sandata | Hawaii Med-QUEST uses Sandata; providers may select an alternate compliant EVV vendor. |
| Idaho | Open Vendor | Sandata | Idaho DHW uses Sandata for aggregation and allows alternate EVV solutions. |
| Illinois | MCO / MMIS | Sandata / HFS | Illinois HFS uses Sandata; MCOs coordinate provider onboarding. |
| Indiana | Provider Choice | Sandata | Indiana FSSA operates a provider-choice model with Sandata as the aggregator. |
| Iowa | MCO / MMIS | HHAeXchange / MCO | Iowa Medicaid MCOs coordinate EVV onboarding; HHAeXchange is broadly used. |
| Kansas | MCO / MMIS | AuthentiCare | Kansas KanCare uses AuthentiCare across managed care plans. |
| Kentucky | Open Vendor | Tellus | Kentucky Medicaid uses Tellus for aggregation and permits alternate EVV vendors. |
| Louisiana | Closed / State-Mandated | Sandata | Louisiana Department of Health uses a state-mandated Sandata solution for personal care services. |
| Maine | Provider Choice | Sandata | Maine DHHS uses Sandata for aggregation and allows alternate EVV vendors. |
| Maryland | Provider Choice | InCasa / Sandata | Maryland Medicaid allows provider choice with data flowing to a state aggregator. |
| Massachusetts | Provider Choice | HHAeXchange | MassHealth uses HHAeXchange as the state aggregator and permits alternate vendors. |
| Michigan | Open Vendor | HHAeXchange | Michigan MDHHS uses HHAeXchange for aggregation and permits alternate EVV systems. |
| Minnesota | Provider Choice | HHAeXchange | Minnesota DHS uses HHAeXchange and allows alternate compliant EVV vendors. |
| Mississippi | Open Vendor | Sandata | Mississippi Medicaid uses Sandata; providers may select an alternate EVV solution. |
| Missouri | Provider Choice | Sandata | Missouri MO HealthNet uses Sandata for aggregation with an open model for alternates. |
| Montana | Provider Choice | Sandata | Montana DPHHS uses Sandata and allows alternate EVV vendors. |
| Nebraska | Provider Choice | Netsmart Tellus | Nebraska DHHS uses Tellus with provider choice for alternate vendors. |
| Nevada | Open Vendor | HHAeXchange | Nevada Medicaid uses HHAeXchange and permits alternate EVV systems. |
| New Hampshire | Provider Choice | Sandata | New Hampshire DHHS uses Sandata; alternate compliant vendors are permitted. |
| New Jersey | MCO / MMIS | HHAeXchange | New Jersey DMAHS uses HHAeXchange; MCOs coordinate onboarding for HCBS providers. |
| New Mexico | Provider Choice | Therap / AuthentiCare | New Mexico HSD supports multiple aggregators depending on program. |
| New York | MCO / MMIS | eMedNY / HHAeXchange | New York uses eMedNY as the state aggregator. MLTC plans commonly require HHAeXchange for CDPAP and personal care. |
| North Carolina | Open Vendor | Sandata | NC DHHS uses Sandata; agencies may choose an alternate EVV solution. |
| North Dakota | Provider Choice | Therap | North Dakota DHS uses Therap for aggregation across HCBS programs. |
| Ohio | Closed / State-Mandated | Sandata | Ohio Department of Medicaid requires use of the state-contracted Sandata EVV solution. |
| Oklahoma | Provider Choice | HHAeXchange | Oklahoma Health Care Authority uses HHAeXchange with an open model for alternates. |
| Oregon | Provider Choice | OR PTC DCI | Oregon uses OR PTC DCI as the state EVV system; providers may use compliant alternates for some programs. |
| Pennsylvania | Provider Choice | Sandata | Pennsylvania DHS uses Sandata as the aggregator; alternates that transmit to Sandata are permitted. |
| Rhode Island | Provider Choice | Sandata | Rhode Island EOHHS uses Sandata for aggregation and allows alternate EVV solutions. |
| South Carolina | Provider Choice | Sandata | South Carolina Medicaid uses Sandata and permits alternate EVV vendors. |
| South Dakota | Provider Choice | Therap | South Dakota DSS uses Therap for HCBS EVV aggregation. |
| Tennessee | MCO / MMIS | MCO-selected | TennCare relies on Managed Care Organizations to select EVV solutions; multiple aggregators may apply. |
| Texas | Closed / State-Mandated | HHAeXchange / HHSC | Texas HHSC operates a state-mandated model. Providers must use one of a limited set of state-approved EVV vendors. |
| Utah | Provider Choice | Sandata | Utah Medicaid uses Sandata and allows alternate EVV vendors. |
| Vermont | Provider Choice | Sandata | Vermont DVHA uses Sandata for aggregation and allows alternate vendors. |
| Virginia | Open Vendor | Sandata | Virginia DMAS uses Sandata; providers may choose an alternate EVV solution. |
| Washington | Provider Choice | IPOne / ProviderOne | Washington HCA uses ProviderOne with IPOne for individual providers. |
| West Virginia | Provider Choice | Sandata | West Virginia BMS uses Sandata for aggregation and permits alternate EVV vendors. |
| Wisconsin | Provider Choice | Sandata | Wisconsin DHS uses Sandata for aggregation; alternates are permitted. |
| Wyoming | Provider Choice | Sandata | Wyoming Department of Health uses Sandata and allows alternate EVV vendors. |
| District of Columbia | Provider Choice | Sandata | DC Medicaid uses Sandata for aggregation and allows alternate EVV vendors. |
Missing EVV data — GPS check-in/out, service code, or client match — is one of the top reasons Medicaid claims are held or rejected.
States and MCOs may pend claims until EVV visits reconcile. Every day of delay costs agencies working capital.
State and federal audits increasingly rely on EVV records. Weak verification data is a common cause of recoupment.
MCOs increasingly require documented EVV workflows before adding new providers to their networks.
Eclipse Scheduling captures every required EVV data element at the point of care: GPS check-in/out, client and caregiver identity, service type, date, and start/end times — with digital signatures on the mobile app — then flows that data straight into billing so claims go out clean.
This guide is informational and not legal advice. Confirm current requirements with your state Medicaid agency and MCOs.