VA Community Care Network Next Generation

VA community care EVV requirements for 2027.

The VA is adding Electronic Visit Verification to home care purchased through its community care network. This guide summarizes what the solicitation documents require of home care providers and the regional contractors, and what agencies can do now.

Short answer

Under the Community Care Network Next Generation contracts awarded on August 31, 2026, the regional contractors must ensure network providers use EVV for all personal care and home health care services that require an in-home visit. Claims that fail any of five EVV matching rules are denied. The contracts' performance period begins January 1, 2027, and each region starts operating when VA issues its regional task order.

Last reviewed October 19, 2026 · Based on solicitation 36C10G26R0003 documents
Timeline

Where things stand.

  1. Dec 15, 2025
    VA issues solicitation 36C10G26R0003, CCN Next Generation Medical, with East and West regions replacing the five current regions.
  2. Feb 24, 2026
    Contractor Manual version 2 includes section 11.3, Electronic Visit Verification.
  3. Apr 9, 2026
    Performance Work Statement version 5 requires contractors to ensure network providers use EVV.
  4. Aug 31, 2026
    VA awards four umbrella contracts: Humana Government Business, Optum Public Sector Solutions, TriWest Healthcare Alliance, and Wellpoint Federal Solutions, under a shared ceiling of up to $1 trillion.
  5. Jan 1, 2027
    Performance period for the umbrella contracts begins. It runs through December 31, 2036.
  6. Pending
    Regional task orders that assign a contractor to the East and West regions. None had been issued as of mid-October 2026.
What the contract requires

Contractor obligations.

  • Ensure network providers use EVV for all personal care and home health care services that require an in-home visit.
  • Collect and verify the six EVV data elements from the 21st Century Cures Act: service type, individual receiving the service, date, location, individual providing the service, and start and end time.
  • Educate network providers on EVV requirements and provide technical support to providers having difficulty.
  • Confirm that EVV data exists for each claim, and resolve discrepancies between the claim and EVV data before submitting to VA.

Source: Performance Work Statement, East, version 5, section 11.3.

Covered services

Codes requiring EVV controls.

From Table 49 of the Contractor Manual, grouped by service type. Check the table for official descriptors and modifiers.

01 · Codes
Personal care and attendant care
S5125T1019
Homemaker
S5130S5131
Home health aide
S9122T1004T1021G0156
Nursing, RN and LPN
S9123S9124T1002T1003T1030T1031G0299G0300
Therapy in the home health setting
G0151G0152G0158G0159G0160G0161G2168G2169
Matching rules

Fail one, and the claim is denied.

  1. Claims cannot overlap service periods.
  2. EVV data elements in the verified visit must match the claimed HCPCS codes, modifiers, and units.
  3. Claims billed over a date span need at least one accepted EVV visit for every date in the span.
  4. Billed units on the claim line must equal the combined billable units of the accepted EVV visits for those dates.
  5. Data elements on the claim must match the data elements on the accepted EVV visit transaction.

Source: Contractor Manual, version 2, section 11.3.

Exclusions

Not subject to EVV.

  • Home health or personal care services that do not require an in-home visit.
  • Services in congregate residential settings where 24-hour service is available.
  • Services rendered by an individual living in the member residence.
  • Services through the Program of All-Inclusive Care for the Elderly (PACE), and hospice services.
  • Services to inpatients or residents of a hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities, or institution for mental diseases.
  • Durable medical equipment.

Source: Contractor Manual, version 2, section 11.3.

For home care agencies

What to do before your region goes live.

  1. Confirm which of your VA-referred services use the codes in Table 49 of the Contractor Manual.
  2. Check that your EVV records carry all six data elements and the same codes, modifiers, and units you bill.
  3. Find out whether your EMR or EVV vendor plans to support the VA regional contractors once they publish specifications.
  4. Watch for provider education from the contractor awarded your region, which the contract requires it to provide.
Where EVV Bridge fits

One feed for Medicaid and VA.

EVV Bridge already validates visit data against aggregator rules and transmits it from the system you use today. Syndech is adding the VA regional contractors as destinations as their specifications are published, so agencies that bill both Medicaid and VA can send both from one source. Your agency keeps ownership of its data and decides how to correct any issue we surface.

Questions

VA community care EVV FAQ.

02 · FAQ

Does the VA require Electronic Visit Verification for community care?

Yes, under the Community Care Network Next Generation contracts. The Performance Work Statement requires each regional contractor to ensure its network providers use EVV to verify all personal care services and home health care services that require an in-home visit.

When does VA community care EVV take effect?

The four Next Generation umbrella contracts awarded on August 31, 2026 have a performance period starting January 1, 2027. Operational start in each region follows the regional task orders, which VA had not issued as of mid-October 2026.

What happens if EVV data does not match a VA community care claim?

Under section 11.3 of the Contractor Manual, failing any one of the EVV matching rules results in claim denial. The rules cover overlapping service periods, matching codes, modifiers, and units, an accepted visit for every date in a span, matching unit totals, and matching data elements.

Which VA services require EVV?

Table 49 of the Contractor Manual lists the codes requiring EVV controls, including personal care and attendant care (S5125, T1019), homemaker (S5130, S5131), home health aide, RN and LPN nursing in the home, and physical, occupational, and speech therapy in the home health setting.

Are live-in caregivers exempt from VA community care EVV?

Yes. The Contractor Manual states that home health or personal care services rendered by an individual living in the member residence do not constitute an in-home visit and are not subject to EVV requirements.

Does the VA require a specific EVV system?

The solicitation documents do not name a single EVV system for providers. They require the regional contractor to collect and verify the six EVV data elements, educate network providers, provide technical support, and confirm that EVV data exists for each claim before submitting it to VA.

Can EVV Bridge send EVV data to the VA regional contractors?

Syndech is adding the VA regional contractors as destinations as their specifications are published. The contractors had not been assigned to regions as of mid-October 2026, so no contractor-specific format exists yet.

Sources

Primary documents.

This page summarizes public procurement records. It is not legal or billing advice, and the regional contractors will publish their own provider guidance.