Pennsylvania EVV Requirements 2026: A Guide for Home Care Agencies

Pennsylvania gives providers a free EVV system, which is good news and is where most summaries stop. The sentence that actually determines what you need to do comes later in the state's own documentation:

The DHS EVV system does not support capturing EVV visits to be submitted to a Managed Care Organization.

The free system is for ODP, OLTL and OMAP fee-for-service personal care and home health clients. If some of your participants come through a managed care organization, those visits cannot go through the free DHS system, and you will need a separate arrangement for them.

For an agency serving both, that means two routes running at once rather than one account covering everything. Working out your split between fee-for-service and managed care is the first thing to do, before evaluating any software.

Most states describe enforcement in terms of corrective action plans and remedies. Pennsylvania is blunter, and it is worth quoting: PA-DHS began to deny PCS claims without a corresponding visit or visits recorded in the PA-DHS EVV Aggregator.

That is the whole enforcement mechanism in one sentence, and it is immediate rather than progressive. No matching visit in the aggregator, no payment for that claim.

Where times disagree rather than a visit being absent, an exception is generated in the DHS Sandata EVV system for you to resolve.

The operational consequence is direct. Unresolved exceptions and visits that failed to transmit are not administrative untidiness in Pennsylvania, they are unpaid claims. Reconciling what is actually in the aggregator against what you are about to bill matters more here than in states with softer enforcement.

DHS has subcontracted with Sandata Technologies for the DHS EVV System. It is genuinely free to providers and it includes three ways of capturing a visit:

• Mobile visit verification through the Sandata Mobile Connect app
• Telephonic visit verification through toll-free numbers, for clients without a smartphone
• A provider portal where office staff manage visits and resolve exceptions

That is a real product rather than a bare compliance pipe, and for a fee-for-service agency it may be all you need. Any vendor telling you Pennsylvania compliance requires buying software is not describing your situation accurately.

Since the free system cannot submit to an MCO, those visits need another path. What the state indicates is that EVV information collected by the MCOs is shared through the DHS Aggregator, and that HHAeXchange interfaces with Sandata.

The practical steps are the same ones we recommend in every managed care state, and they are not optional here:

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

Do not assume the answer is the same across plans, and do not assume your fee-for-service setup carries over.

Pennsylvania uses an open EVV model. Providers may use an Alternate EVV system so long as it captures the six required EVV data elements and can integrate with the PA-DHS Aggregator.

Transmission uses Sandata's standard data specification, and the aggregator includes a read-only web portal where providers can view their own data, alongside a payer portal with alerts, real-time views and reporting.

Providers interested in an approved third-party system, or with questions specific to Alternate EVV, can contact the Sandata Alternate EVV support team to confirm the data interfaces align.

The read-only provider portal is worth knowing about regardless of which route you take. It is where you can confirm what the state actually holds, which is the only view that matters when a claim is denied.

Pennsylvania EVV spans three offices within DHS, and which one you deal with depends on the program your participants are in:

• OLTL, the Office of Long-Term Living
• ODP, the Office of Developmental Programs, which publishes its own EVV guidance document
• OMAP, the Office of Medical Assistance Programs

All of them feed the same PA-DHS EVV Aggregator, so the destination is shared even where the program rules and claims contacts differ. If you serve participants across more than one office, check whether the office-specific guidance adds anything to the baseline, particularly ODP, which maintains a separate guidance document.

• Personal care services: 1 July 2020. As of that date, providers are required to use EVV to receive payment for any claim for PCS visits.
• Home health care services: 1 January 2023, with a Pennsylvania soft launch period that ran from 10 August 2022 to 31 December 2022. The DHS EVV system was updated to include HHCS in August 2022.

Pennsylvania's personal care date is notable for tying EVV directly to payment from the start, rather than phasing enforcement in later. The home health date matches the federal deadline described on our Cures Act page.

For the free fee-for-service system, the state describes this path:

1. Your EVV System Administrator completes mandatory training. It is free and online, through the Sandata Learning Management System, and registration uses your 9-digit Medicaid Provider ID.
2. Sandata sends a Welcome Kit by email, typically within three business days.
3. Create your employee accounts in the system.
4. Train your staff, using the video library and reference guides provided.

One instruction from the state worth repeating, because it is easy to get wrong when you are learning a system: do not enter training data or dummy data in the DHS EVV system. It is a live system feeding a live aggregator.

If any of your participants are managed care, run the MCO steps above in parallel. Neither setup covers the other.

Points we could not establish clearly enough from an official source to publish:

• Whether HHCS claims are denied on the same basis as PCS. The claim denial statement we found refers specifically to PCS claims. Whether home health claims are treated identically is worth confirming with DHS rather than assuming.
• Which MCOs require which systems. We can tell you MCO data reaches the DHS Aggregator and that HHAeXchange interfaces with Sandata. The specific requirement for each plan is a question for that plan.
• The full list of covered services by office. ODP, OLTL and OMAP publish their own program materials, and mapping your service codes is a question for the relevant office.
• Any cost associated with Alternate EVV integration. We found the interface requirement but not a statement about who bears associated costs.

• PA DHS EVV: pa.gov DHS EVV, including the free solution page, the FAQ and Alternate EVV guidance
• Provider Assistance Center: 800-248-2152, option 1 for EVV, or papac1@gainwelltechnologies.com
• Policy questions: RA-PWEVVNOTICE@pa.gov
• Sandata Alternate EVV support team, for third-party system interface questions
• Your managed care organizations, individually, since the free system cannot serve them