Florida EVV Requirements 2026: A Guide for Home Care Agencies

Almost every article about Florida EVV tells you the state gives you HHAeXchange free. That is true, and for a lot of agencies reading it, it is also beside the point.

Florida Medicaid runs on two tracks, and they have different EVV arrangements:

• Fee-for-service. Billed directly to Florida Medicaid through AHCA. This is the track the October 2024 HHAeXchange transition applies to.
• Statewide Medicaid Managed Care. Billed to a managed care plan you contract with. Most long-term care and personal care for Florida adults is delivered this way, and each plan sets its own EVV expectations.

If you run non-medical home care and your Medicaid clients came to you through a long-term care plan, then the AHCA fee-for-service announcement is not describing your situation. Your EVV path is set by the plans you contract with, and an agency working with three plans can face three arrangements.

Work out which track your visits are billed under before reading anything else about Florida EVV, including the rest of this page.

AHCA uses what it calls an Open Vendor Model. In the agency's own framing, that means providers may use the state's EVV system at no cost, or use another EVV system of their choosing that integrates with the state's system.

This is the more permissive of the two common arrangements. Compared with a closed model, where a state mandates one system and that is the end of it, Florida leaves you a genuine choice on the fee-for-service side.

The important caveat, stated plainly by AHCA: providers who elect to use a third-party EVV system are still required to have an HHAeXchange portal. Choosing your own system changes where visits are captured. It does not remove the state system from your life.

The rule behind Florida's home health EVV program is Florida Administrative Code 59G-4.132, Home Health Electronic Visit Verification Program, effective 22 February 2017, adopted under the authority of section 409.919 Florida Statutes and implementing section 409.9132.

Following a competitive procurement, AHCA contracted HHAeXchange as its EVV vendor and offers the system to fee-for-service providers at no cost. It went live on 1 October 2024, replacing the previous vendor arrangement associated with Netsmart and Tellus.

That transition date matters when you are researching. Florida EVV material referring to Mobile Caregiver+ or pointing at Netsmart training resources may predate October 2024, and some of it is still in circulation. Check the date on anything you read, including material still linked from official pages.

What the sponsored HHAeXchange portal provides, according to HHAeXchange's own published materials, is more than bare EVV:

• Electronic visit verification and a provider portal
• A scheduling module
• A caregiver mobile app for iOS and Android, available in more than twenty languages
• Telephony, so a caregiver can clock in and out by phone
• Electronic receipt of member demographics, authorizations and care plans from the payer
• Pre-billing claims scrubbing

The multilingual app is worth noting given Florida's workforce. Billing, payroll and accounts receivable are part of HHAeXchange Enterprise, a paid product sold on top of the sponsored portal, rather than the free portal itself.

Statewide Medicaid Managed Care Long-Term Care is where most Florida personal care for adults is delivered. EVV requirements there flow through the plan rather than through the AHCA fee-for-service program.

Several Florida plans use HHAeXchange for EVV and for passing visits into claims, and did so well before the fee-for-service transition. Plans publicly associated with HHAeXchange in Florida include Humana, Sunshine Health, Molina Healthcare, Children's Medical Services and Florida Community Care.

Do not assume from that list that every plan works the same way, or that being set up with one plan covers another. The practical steps are:

1. List every plan you are contracted with
2. Ask each one which EVV system it requires and whether a third-party system is permitted
3. Ask each one what integration involves and how long onboarding takes
4. Get the answers in writing where you can

This is tedious and it is the single most useful hour you can spend, because a wrong assumption here shows up later as denied claims.

The federal requirement, which Florida is implementing, applies to Medicaid-funded personal care services and home health services that require an in-home visit. AHCA's fee-for-service EVV program is administered as a home health services program under rule 59G-4.132.

For fee-for-service, AHCA requires home health agency providers rendering services through the fee-for-service delivery system to register and create an EVV Dashboard profile in the state EVV system in order to schedule services or submit claims for reimbursement.

Two boundaries worth being clear about:

• Private pay is outside it. The requirement follows Medicaid funding. A client paying you directly is not a Medicaid visit.
• Other payers set their own rules. Long-term care insurance, VA programs and similar payers are not governed by this requirement, though they may have verification rules of their own.

Whether a specific service you deliver falls inside the program is a question for AHCA or your plan. We are not going to guess at service code level, because getting that wrong would be worse than not answering.

Florida's system records visits in compliance with section 12006(a) of the 21st Century Cures Act, which means the six federal data elements:

1. The type of service performed
2. The individual receiving the service
3. The date of the service
4. The location of service delivery
5. The individual providing the service
6. The time the service begins and ends

AHCA describes the state system as verifying the type of service performed, the date, time and location of the service, and the person receiving and the person providing it.

More detail on what these mean in practice, and on what the federal law does not require, is in our plain-English EVV explainer.

If you are a fee-for-service home health provider, the sequence AHCA describes is:

1. Register with HHAeXchange. Complete the provider agency registration for Florida. Existing HHAeXchange users indicate this on the registration form rather than creating a duplicate relationship.
2. Create your EVV Dashboard profile. AHCA requires a profile for your home health agency in the state EVV system before you can schedule services or submit claims for reimbursement.
3. Set up your caregivers. Add staff and get them onto the mobile app or telephony, whichever suits the homes you serve.
4. Confirm your data flows. Before you rely on it, check that visits you capture are visible where the payer expects them.

If your Medicaid work is managed care, start with the plans instead. Registration for AHCA fee-for-service does not enrol you with a plan, and vice versa.

Florida's open vendor model permits a third-party system for fee-for-service, provided it integrates with the state system. Based on HHAeXchange's published integration materials, that normally involves:

• Completing the provider registration questionnaire and declaring the third-party system you intend to use
• Coordinating with HHAeXchange's integrations team to establish the interface
• Your vendor building to the published EDI specifications, including the provider integration visit import and EDI export interface guides
• Keeping an HHAeXchange portal account regardless, which AHCA requires

Two questions to put to any vendor claiming Florida integration: are they live with Florida agencies today, and how long does onboarding actually take. There is a real difference between a vendor who has done this many times and one who is willing to try.

Before you go down this road at all, it is worth asking whether you need to. The sponsored portal is free and satisfies the requirement on its own. Our comparison of CareVerify and HHAeXchange sets out honestly when a second system is worth paying for and when it is not.

Three things we could not confirm from an official source, so we are not publishing them rather than guessing. Each matters, and AHCA can answer all three:

• AHCA's current dedicated EVV support number. A toll-free EVV line appears in circulating material alongside Netsmart-era resources that predate the October 2024 transition, so we cannot confirm it is still the right number.
• The exact current registration URL. Links we found were inconsistent, including one pointing at a different vendor entirely. Go through AHCA's own EVV page rather than a link from a third party, including this one.
• The specific penalty provision for non-compliance. The practical consequence is documented, that you cannot schedule services or submit claims without registering, but we did not find a citable sanction provision and will not paraphrase one.

We would rather this page had gaps you can see than confident statements you cannot check. If you get a definitive answer from AHCA on any of these, tell us and we will add it with the source.

Go to the source rather than relying on any vendor page, this one included.

• AHCA Home Health EVV: the agency's own EVV page, which carries current registration steps and contacts
• AHCA Medicaid provider line: 1-800-289-7799
• HHAeXchange Florida support: 1-646-821-8646, and the Florida information center
• The rule: Florida Administrative Code 59G-4.132
• Your managed care plans, individually, if any of your Medicaid work runs through them

The Home Care Association of Florida also circulates provider updates when AHCA changes something, which is a reasonable way to hear about transitions before they affect your claims.