2026 EVV Compliance Guide: All 50 States
The most comprehensive Electronic Visit Verification compliance reference for home care agencies. State aggregators, vendor requirements, hard edit deadlines, and official Medicaid links — all in one place.
What is Electronic Visit Verification?
EVV is a federally mandated technology system that electronically verifies home care service visits under Medicaid.
21st Century Cures Act — Section 12006
Signed into law December 13, 2016, Section 12006 of the 21st Century Cures Act requires all state Medicaid programs to implement EVV for Personal Care Services (PCS) and Home Health Care Services (HHCS). The law aims to prevent fraud, reduce billing errors, and ensure patients receive authorized care.
6 Required Data Elements
Federal Deadlines
- PCS: January 1, 2020
- HHCS: January 1, 2023
Penalty for Non-Compliance
Up to 1% FMAP reduction for states that fail to comply, unless good faith effort is demonstrated.
EVV Implementation Models
Open Model
40 statesState provides a free EVV vendor but allows agencies to choose alternative systems that integrate with the state aggregator.
Closed Model
5 statesAll agencies must use the state-mandated EVV system. No alternative vendors permitted.
Provider Choice
6 statesNo free state option. Agencies select and pay for their own EVV solution that integrates with the state aggregator.
MCO Choice
0 statesManaged Care Organizations select the EVV vendor. Agencies must use the system chosen by their MCO.
State-by-State EVV Requirements
Select any state to view its EVV aggregator, model, requirements, and official resources.
= Hard edit enforcement active or scheduled
Key EVV Deadlines: 2025 – 2028
Critical compliance dates for home care agencies. Dates in amber require immediate attention.
June 25, 2025
NPI hard edit — claims declined without NPI linked to EVV
August 1, 2025
PDN/Nurse claims denied without EVV data
October 1, 2025
HHCS hard launch — claims denied without validated EVV data
December 1, 2025
All EVV claims required through HHAeXchange
January 1, 2026
50% compliance threshold in effect
January 7, 2026
Soft launch with warning codes on non-EVV claims
January 30, 2026
Providers must use EVV before submitting claims
March 2, 2026
HHAeXchange portal go-live for DOA/DRS providers
April 2026
Hard edits begin — claims denied without matching EVV data
April 1, 2026
Compliance monitoring begins for DOA/DRS providers
Mid-2026
Real-time claim processing rollout
July 1, 2026
80% compliance threshold takes effect
Fall 2026
Transition to Acumen Fiscal Agent system
September 1, 2028
Alternative devices must be below 5% of all check-ins
EVV Vendor Map
Which aggregator or vendor serves your state? Some states appear under multiple vendors when the aggregator differs from the default EVV system.
HHAeXchange
11 states
Sandata
16 states
AuthentiCare (Fiserv)
7 states
Netsmart
4 states
Therap
4 states
CareBridge
4 states
State-Built Systems
5 states
State-Built Systems
- California: CalEVV
- Oregon: eXPRS
- Maryland: LTSSMaryland (ISAS)
- Louisiana: LaSRS
- Arizona: AHCCCS In-House Aggregator
Frequently Asked Questions
Common questions about EVV compliance for home care agencies.
Sources & Disclaimer
Last updated: March 2026
Important: EVV requirements change frequently. Always verify current requirements with your state Medicaid agency before making compliance decisions. This guide is provided for informational purposes only and does not constitute legal or regulatory advice.
Official Federal Resources
AveeCare's EVV: Compliant in Every State
AveeCare's EVV system supports all 50 states with GPS tracking, signature capture, 9 export formats (HHAeXchange, OpenEVV, AuthentiCare, Netsmart, Therap, CareBridge, and more), automatic validation with 19 compliance checks, and AI-powered secondary validation — all built into every visit.