What is EVV? The six data elements, explained with examples

Electronic Visit Verification, or EVV, is a record made at the time of a home visit that shows the visit really happened: who came, for whom, what they did, where, and from when to when. For Medicaid-funded personal care and home health care, states are required to use it. For everyone else, from cleaning companies to security firms, it is simply good proof of work.

This guide explains where the requirement comes from, the six data elements every visit record needs, how visits are captured, and the problems that cause most rejected or questioned visits.

Where the requirement comes from

Section 12006 of the federal 21st Century Cures Act, signed in December 2016, requires state Medicaid programs to use EVV for personal care services and home health care services that include an in-home visit. States that did not put EVV in place by the deadlines risked a reduction in federal Medicaid funding. As reported by CMS, the deadline for personal care was January 2020 and for home health care January 2023, with one-year extensions available to states that showed a good faith effort. By now every state should run EVV for both, but the details, including which programs and services are covered, are set by each state. Check your state Medicaid agency's EVV page for the services that apply to you.

EVV is a Medicaid rule. Private-pay clients, long-term care insurance and Medicare home health are not covered by the federal EVV requirement, although some payers ask for similar proof in their own contracts.

The six data elements

The law lists six things an EVV system must verify for each visit. Here they are with an example from a typical personal care visit.

#	Element	Example	How it is usually captured
1	Type of service performed	Personal care, code T1019	The service on the scheduled visit, confirmed by the worker
2	Individual receiving the service	Dorothy H., Medicaid member ID	The client record linked to the visit
3	Date of the service	Monday 19 October	Stamped by the system, not typed by the worker
4	Location of service delivery	GPS position 40 m from the client's home	Phone GPS at clock in and clock out, or a call from the client's landline
5	Individual providing the service	Maria L., worker ID W-0001	The worker's own login on their phone
6	Time the service begins and ends	9:02 AM to 11:01 AM	Clock in and clock out times from the system clock

Most states ask for more than the six, for example the payer, the agency's Medicaid provider ID, the tasks performed, and a reason code whenever a visit is entered or changed by hand. Your state's EVV specification lists the exact fields.

How visits are captured

There are three common ways to record a visit:

• Mobile app with GPS. The worker clocks in and out on a smartphone. The app records the time and the phone's position. This is the most common method.
• Telephony. The worker calls a toll-free number from the client's landline. The phone number stands in for the location.
• Fixed device. A small device in the client's home shows a code that the worker records at the start and end. It is used where there is no landline and no mobile signal.

Whichever method you use, the record should be made at the time of the visit. A visit typed in afterwards by the office is allowed in most states, but it is flagged as a manual visit and needs a reason.

What a good visit record looks like

Think of the record from an auditor's point of view. They will want to see:

• All six elements, captured automatically wherever possible.
• The original captured times kept, even when the office corrects them.
• A reason code and the name of the person for every change, with the time of the change.
• The GPS accuracy alongside the position, so a reading of "200 meters away, accuracy 180 meters" is not treated as fraud.
• The tasks done during the visit and a note, which link the time to the plan of care.
• The client's or representative's signature where your state or payer asks for one.

The problems that cause most exceptions

Forgotten clock in or clock out

The most common exception. The fix is a reminder a few minutes after the scheduled start and end, and an office review with a reason code such as "worker forgot to clock out". Some states limit how many manual edits an agency may make before it draws attention, so watch the rate per worker.

Clock in away from the home

A worker clocking in from the car park is usually harmless; one clocking in from home is not. A geofence, a circle of a set radius around the client's address, separates the two. A position outside the circle should become an exception for review, not an automatic rejection, because GPS indoors can be off by 50 meters or more.

Service delivered away from the home

Personal care sometimes happens in the community: a doctor's appointment, a grocery trip. Many states allow it with a specific reason code. Check your state's list.

Wrong client or wrong service

A worker with two clients in the same building may clock in to the wrong one. The record must be corrected, with a reason, before it is billed.

Visits that do not match the claim

In many states the claim is matched against the EVV record. If the units on the claim are more than the verified time supports, the claim can be denied. Bill from the verified visit, not from the schedule.

EVV outside Medicaid

The six elements answer the questions any customer asks about work done at their address. A cleaning company proves the team arrived and stayed. A security company proves the post was covered. A staffing agency gets hours the client cannot dispute. The same record, with a customer signature, also settles payroll questions before they start.

Checking your own data

Export a week of visits as a CSV and run it through the free EVV visit record checker. It runs in your browser and flags every row missing one of the six elements, times out of order and edits without a reason. Then compare your exception rate week by week: a falling rate is the clearest sign that workers and office have settled into the process.

For how states differ in which system you must use, read EVV by state: open, closed and hybrid models.