EVV requirements by state: how they differ

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The federal floor, in the statute’s own words

One section of the Social Security Act sets the floor every state builds on, and it is shorter than most summaries of it.

Section 12006 of the 21st Century Cures Act added subsection (l) to 42 U.S.C. § 1396b. It does not order a state to buy anything. From calendar quarters beginning January 1, 2020 for personal care visits and January 1, 2023 for home health visits, 42 U.S.C. § 1396b(l)(1) reduces the federal medical assistance percentage unless the state is exempt or requires the use of an electronic visit verification system for them. Under 42 U.S.C. § 1396b(l)(3), a state that already required such a system for both services on December 13, 2016 is exempt from that reduction for as long as it keeps requiring one; under § 1396b(l)(4), a separate good-faith exemption covered only calendar quarters in 2020 for personal care and 2023 for home health. The reduction rises in steps to one percentage point, reached in 2023 for personal care and in 2027 for home health. The CMS page on the program puts the dates plainly: states had to put EVV in place for Medicaid personal care services by January 1, 2020 and for home health services by January 1, 2023.

The statute also tells states how to get there. Under § 1396b(l)(2), a state consults the agencies that deliver these services, takes stakeholder input from beneficiaries and family caregivers among others, and gives the workers who use the system a chance to be trained on it. Paragraph (6) carries the money: a state that operates the system, itself or through a contractor, receives a 90 percent federal share of building it and 75 percent of running it, and a state that has providers use a system it does not operate gets neither.

Six items, one of which concerns place

Paragraph (5)(A) defines an EVV system by what it verifies about each visit: the type of service performed, the individual receiving the service, the date of the service, the location of service delivery, the individual providing the service, and the time the service begins and ends. That is the full federal list. Everything else on a state’s EVV page — which app, which aggregator, how GPS is treated, what happens to a manually edited visit — is that state’s own choice.

Where the states part ways

• Who runs the system. Pennsylvania’s Department of Human Services describes an open model, with a state option developed together with Gainwell Technologies and Sandata, on its EVV page, which we read on October 6, 2026.
• How location is captured. The federal list asks for the location, not for GPS. Pennsylvania’s questions-and-answers page names four accepted methods as of October 6, 2026, and a GPS phone app is one of them. Ohio’s Medicaid department, in a workgroup deck dated September 28, 2026, describes revised rules bringing GPS location at clock-in and clock-out, anticipated for July 1, 2027, with a waiver for some individuals, including people who live with a family-member caregiver.
• What happens to edited visits. Pennsylvania measures the share of visits verified without a manual edit against a threshold set in a Department of Human Services bulletin; the Pennsylvania manual-edit threshold is walked through on its own page. Ohio’s deck of September 28, 2026 says manual entry “will remain permitted when a caregiver cannot safely stop providing care.”
• Statute, rule and proposal. A state can have a law in effect, rules that have not caught up, and a proposal whose comments the department is still reviewing, all at once. Ohio is the clearest case right now, and the Ohio EVV requirements page keeps those layers separate.

States covered so far

Each covered state has its own page, built from that state’s own sources. Each covered state below is dated and names where it comes from.

• Ohio — Revised Code 5164.42 took effect on October 6, 2026; Ohio Medicaid’s September 28, 2026 workgroup deck says EVV policy does not change until its rules are revised, which it anticipates for July 1, 2027.

Sourced on this page; dedicated page pending: Pennsylvania. The sentences on this page that mention it name their sources; its own requirements page is not built yet.

Not yet covered: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming. A name here means we have not yet built that state’s own page; where one of these states is mentioned above, the sentence names the source it comes from.

Where LockProof sits in this picture

For how a second, photo-based file sits next to a certified system without getting in its way, see visit-proof apps that run alongside EVV, and for the capture itself, how the capture works.

The limits of this page

Each line here is a reading of a source on the date shown, and states change their rules. The federal statute is quoted as published in the U.S. Code and read on October 7, 2026, and the CMS page as it stood on October 6, 2026. No agency’s programs, waivers or contracts were checked against any of it; that is work for counsel or the state’s Medicaid office rather than for a vendor.