EVV Requirements by State.

A guide to Electronic Visit Verification requirements across the United States: what your state requires, which aggregator it uses, and how EVV Bridge transmits to it.

What is EVV?

Understanding the 21st Century Cures Act EVV mandate.

A federal requirement with 50 state implementations. Here is the baseline.

01 · Background

Federal mandate, state-specific implementation.

The 21st Century Cures Act, signed into law in December 2016, requires all states to implement Electronic Visit Verification (EVV) for Medicaid-funded personal care services and home health care services that require an in-home visit.

EVV electronically verifies that home care visits occur by capturing six data points every time a caregiver arrives, performs care, and clocks out.

CMS guidance: “EVV is designed to help ensure that services are delivered in accordance with an individual's plan of care while providing accountability and combating fraud, waste, and abuse.”
01
Type of service
What care was provided during the visit.
02
Individual receiving service
The patient identified for the scheduled visit.
03
Date of service
The calendar date on which the visit occurred.
04
Location of service
Where care was delivered, verified to the care location.
05
Individual providing service
The caregiver recorded as present for the visit.
06
Time service begins and ends
Clock-in and clock-out timestamps spanning the visit.
State-by-state requirements

Each state has chosen its own EVV system and aggregator.

Select a state to see its aggregator. Don't see yours? Reach out and we will confirm the aggregator and setup for your state.

02 · Coverage
12 / 12 shown · more on request
State detail · TX
Texas

EVV submissions in Texas are transmitted to TMHP. EVV Bridge maps, validates, and transmits visit data and surfaces issues so your team can act on them. Most aggregators require vendor testing before go-live, which we complete with your agency during onboarding.

View Texas details →
AggregatorTMHP
SyndechPlanned
Common EVV challenges

What usually breaks.

Six recurring friction points — the ones agencies tell us about on day one.

03 · Challenges

Manual upload burden

Agencies spend 3–5+ hours weekly on manual EVV data uploads to state systems.

Formatting errors

Data formatting errors in EVV submissions are a leading cause of rejected records and delayed payments.

Changing requirements

State aggregators frequently update specifications, requiring constant vigilance.

Multi-state complexity

Agencies operating in multiple states must manage different systems and formats.

Cash flow impact

EVV errors delay reimbursements, creating cash flow problems for agencies.

Limited IT resources

Small agencies lack the technical staff to build custom EVV integrations.

How Syndech helps

Automated EVV transmission, state by state.

04 · Solution

We automate the transmission. You stay in control of your data.

EVV Bridge automates the EVV data transmission process end to end. We pull your visit data, validate it against state-specific requirements, and transmit it directly to your state aggregator in near real-time.

  • 01No manual uploads or re-keying
  • 02Per-record acknowledgement tracking
  • 03Data issues surfaced before transmission
  • 04Sandata and HHAeXchange connectors first, more aggregators to follow
6
EVV data elements
Checked on every visit before transmission.
1 feed
From your EMR
Routed to each aggregator you bill through.
2 payers
Medicaid and VA
VA destinations added as contractor specs publish.
30 d
Onboarding
Standard implementation window.