North Carolina EVV requirements by health plan

North Carolina EVV, date by date

Personal care went first in 2021; home health took two launches, one per payer type.

Dates come from the NC Medicaid bulletin named in each row; all were opened on October 23, 2026.

Quoted from NC Medicaid

On the aggregator, the EVV page says Sandata “collects all captured visit data for NC Medicaid, regardless of the original source.” On hand entries, the January 29, 2024 bulletin says they “will not cause a claim to deny; however, they should be kept to a minimum of 15% or less.” On home health in managed care, NC Medicaid’s September 9, 2025 bulletin is direct: “Claims for these services, with dates of service on, or after, Oct. 1, 2025, without the required EVV data will be denied.”

Three vendors and one aggregator

The EVV page splits the work by plan. Sandata runs the free system for NC Medicaid Direct and also gathers every visit for the state; CareBridge is free for Healthy Blue members; HHAeXchange is free for the other Standard Plans, the LME/MCOs and the Tailored Plans. An agency can bring a vendor of its own for any of them, and that vendor then sends visits to the plan’s system, which passes them on to Sandata. The August 4, 2021 bulletin adds that the aggregator costs nothing for agencies using another vendor, and that Sandata’s free system covers only NC Medicaid Direct visits.

Personal care and the waivers

The EVV page lists personal care, home health, CAP/C, CAP/DA, self-directed personal attendant care, the Innovations and TBI waivers and the 1115 managed care demonstration, and it leaves private duty nursing and CAP/C nurse respite out. Per NC Medicaid’s bulletin of October 28, 2021, CAP/C and CAP/DA personal care claims from June 1, 2021 need EVV data in NCTracks, except for a paid live-in caregiver, whose agency bills with place of service code 99, signs an attestation and keeps two proofs of a shared address, one of them a photo ID, checked every six months. For the Innovations and TBI waivers, the EVV page says EVV began July 1, 2021 and that family members living in the beneficiary’s home are outside it.

Home health care, in two launches

NC Medicaid Direct went first: its home health hard launch, which the September 9, 2025 bulletin dates to October 1, 2023, ties payment to verified visit data. The managed care plans took longer. According to the March 27, 2025 bulletin, Standard Plans went back to a soft launch on February 15, 2024 and Tailored Plans started one on July 1, 2024, and home health rates rose 10 percent from February 1, 2023 to help with the work. Under NC Medicaid’s bulletin of September 9, 2025, a managed care home health claim covering a service date on or after October 1, 2025 is denied without EVV data, and the revenue and service codes on the claim must match the visit record. The plans also offer agencies with home health taxonomy 251E00000X a way to bill the plan directly.

Recording a visit, and edits

The April 16, 2024 bulletin names three ways to capture a visit: the mobile app, which NC Medicaid prefers; a call from a phone registered to the beneficiary’s record; and a fixed visit verification device, which an agency on the state’s Sandata system can buy through Sandata for a one-time $85 per device, or lease. The app goes on the caregiver’s phone, never the beneficiary’s. When none of them works, an agency may enter a visit by hand, and the EVV page asks for electronic capture at least 85 percent of the time, with hand entries at 15 percent or less. For NC Medicaid Direct, the March 8, 2024 bulletin adds that NCTracks denies a claim that reuses one visit key across dates, beneficiaries, provider numbers or procedure codes, and providers who alter EVV data to reuse a key face referral for investigation.

Primary texts and anything reported

Every statement above traces to an NC Medicaid page or bulletin listed at the top. No news item, vendor post or law firm summary was used. The plans’ own EVV pages and code crosswalks were not opened.

Outside the scope of this reading

No North Carolina statute, administrative rule or clinical coverage policy on EVV was read. Health plan contracts and the vendors’ technical guides were not read either, and the older stakeholder decks and FAQs on the EVV page were set aside in favor of the dated bulletins.

LockProof and a North Carolina agency

North Carolina’s EVV visits flow to Sandata and the health plans. LockProof photos serve relatives and clients paying out of pocket who want to see a visit for themselves. The difference is laid out in tools that sit beside an EVV system and the parts of a caregiver photo record.

Reading date and other states

The NC Medicaid texts above date from an October 23, 2026 reading, so a later bulletin may not be reflected. Pages for other states sit in the EVV state directory, and Georgia’s is the Georgia EVV requirements page.