Electronic Visit Verification (EVV) Requirements
Date: 09/14/26
This only applies to: Personal Care & Home Health Providers (Missouri Medicaid)
Effective Date: Home State Health will begin requiring EVV September 21, 2026
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Electronic Visit Verification (EVV): What It Is and How It Works (PDF)
Overview
Electronic Visit Verification (EVV) is a federally mandated system used to verify that home and community-based services were delivered as authorized. EVV electronically records and validates visit information for personal care and home health care services to help ensure members receive approved services and that providers are accurately reimbursed. EVV requirements were established under the 21st Century Cures Act and are used by Medicaid programs nationwide.
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Key Information Captured by EVV
EVV systems typically capture:
- Member/Participant Medicaid ID
- Date of service
- Time the service began and ended
- Provider Medicaid ID
- Caregiver information
- Procedure code and modifier
- Number of service units provided
These data elements are used to verify service delivery and support claims payment.
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How EVV Works
Step 1: Service Is Delivered
A caregiver visits the member and provides the authorized service. The caregiver records the visit electronically using an EVV-approved system.
Step 2: Visit Data Is Submitted
The providers EVV vendor transmits visit information to the EVV Aggregator Solution (EAS). Providers are responsible for ensuring visit data is submitted accurately and timely.
Step 3: Visit Verification
The EAS reviews the visit and places it in a verified status when all required information is present and valid. Providers should regularly review the EAS to ensure visit records are complete and accurate.
Step 4: Claim Submission
The provider submits a claim through the normal claims submission process. No special claim submission method is required.
Step 5: Claims Validation
The claim is compared against the verified EVV visit in the EAS. The following elements must match:
- Member Medicaid ID
- Date(s) of Service
- Provider Medicaid ID
- Procedure Code/Modifier
- Number of Units
If all required data matches, the claim can continue through payment processing.
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Why EVV Is Important
Improves Program Integrity
EVV helps verify that authorized services were delivered to eligible members and reduces the risk of improper billing.
Supports Claims Accuracy
Matching claims to verified visits improves payment accuracy and reduces the need for rework and corrections.
Enhances Compliance
Providers are required to comply with EVV requirements and maintain accurate visit records. Noncompliance may result in administrative action or claim denials.
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Frequently Asked Questions
Does EVV change how claims are submitted?
No. Claims are submitted through existing claims processes. EVV adds a validation step that compares claim information to verified visit data
What happens if no matching EVV visit is found?
Claims may be denied if a corresponding verified EVV visit cannot be matched to the claim.
How often should providers review EVV data?
Providers are expected to routinely review their EAS records to ensure visits are accurate, complete, and verified.
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Summary
Electronic Visit Verification (EVV) is a required process that electronically documents and verifies home-based healthcare services. EVV data must accurately match the information submitted on claims, including the member ID, service dates, provider ID, procedure codes/modifiers, and units. By ensuring visit information is complete, verified, and transmitted to the EVV Aggregator Solution, providers can reduce claim denials and maintain compliance with Medicaid requirements.
Resources:
MO-DSS Dedicated Page, See "Education & Training"
https://mydss.mo.gov/mhd/evv