Texas EVV Requirements 2026: A Guide for Home Care Agencies

If you have read about EVV in another state, set that aside for a moment. Texas runs one of the more structured programs in the country and three things about it are unusual enough to lead with.

Texas measures your compliance with a number. Not a vague expectation that you use the system, but a quarterly EVV Usage Score with a published minimum and a defined enforcement ladder. Most states do not publish anything comparable.

Using your own software requires approval, not just integration. An EVV Proprietary System in Texas goes through a formal request and onboarding process and carries continuing obligations afterwards.

The aggregator and the EVV system are run by different organizations. That distinction matters more here than in states where one company does both.

This is the number to write down. Program providers and FMSAs must achieve and maintain a minimum EVV Usage Score of 80%, rounded to the nearest whole percentage, in each state fiscal year quarter, unless HHSC notes otherwise.

Two details that catch people out:

• The Texas fiscal year starts on 1 September. Your quarters are not calendar quarters, so the period being scored may not be the one you assume.
• Reviews happen after visit maintenance closes. The score is assessed once the visit maintenance time frame for the quarter has expired, so corrections made after that window do not help the quarter they belonged to.

The practical consequence is that unresolved visits are not an administrative untidiness. They are a number that a payer will read at the end of the quarter, and the window to fix them closes.

Texas publishes a progressive enforcement schedule, counted by occurrences within a rolling 24-month period. Payers, meaning HHSC and the managed care organizations, conduct the reviews.

• First occurrence in 24 months. The payer requires additional EVV training, to be completed within 20 business days. The following quarter is then reviewed, and if you are compliant no further action follows.
• Second and subsequent occurrences. A corrective action plan, to be completed within 10 business days.
• Three quarters of non-compliance within 24 months. The payer may propose contract termination, after the earlier steps have been followed.

Separately, and this is the one with immediate cash flow consequences: where a provider fails to complete required training or corrective action plan requirements, the payer may temporarily withhold Medicaid claims payments until those requirements are met.

For CDS employers, sustained non-compliance can lead to a recommendation for removal from the CDS option.

One current change worth knowing: HHSC no longer implements compliance grace periods, effective 30 January 2026. Guidance written before that date may describe a leniency that no longer exists.

Texas gives program providers and FMSAs a choice between two paths.

The state-provided EVV system

HHSC provides an EVV system for providers to use. The state-provided EVV system vendor is HHAeXchange, reachable on 833-430-1307. Using it is the straightforward path: no approval process, no interface to build, and the data reaches the aggregator without you arranging it.

An approved EVV Proprietary System

Alternatively you may use what Texas calls an EVV Proprietary System, defined as an approved EVV system that a program provider or FMSA may use instead of the state-provided system to exchange EVV data with the EVV Aggregator.

The word doing the work in that definition is approved. This is covered in its own section below, because the obligations are more substantial than most agencies expect.

On cost, the handbook is explicit: HHSC does not directly reimburse program providers and FMSAs for the use of an EVV proprietary system. Those costs can be reported through Medicaid cost reporting processes, which HHSC considers when setting future rates.

Three organizations appear in Texas EVV and they do different things. Knowing which is which saves a lot of misdirected phone calls.

• HHSC, the Texas Health and Human Services Commission, sets EVV policy and publishes the EVV Policy Handbook.
• TMHP, the Texas Medicaid and Healthcare Partnership, is the Medicaid claims administrator and is responsible for managing the EVV Aggregator, the claims matching process and the EVV Portal. TMHP also oversees proprietary system approval on HHSC's behalf.
• Your managed care organization, if your clients come through managed care, is a payer that conducts compliance reviews alongside HHSC.

Notice the structure: the EVV system you capture visits in and the aggregator your data must reach are run by different organizations. That is a cleaner separation than in some states, and it is a useful illustration of what an aggregator actually is: the central collection point, not the app on the phone.

Texas has historically had more than one state EVV vendor. TMHP previously selected DataLogic Software, known as Vesta, and First Data Government Solutions, known as AuthentiCare, on HHSC's behalf.

Providers on those systems transition to HHAeXchange unless they are approved to use a proprietary system.

If you are still on Vesta or AuthentiCare, or if your reference material mentions them as current options, that is the first thing to resolve with HHSC or TMHP. It also means older Texas EVV guidance you find online may describe a vendor landscape that has changed.

Texas EVV policy addresses several categories of party, and the vocabulary is specific to the state:

• Program providers, the agencies delivering services
• Financial Management Services Agencies (FMSAs), supporting the consumer directed services option
• CDS employers, individuals directing their own services under the CDS option
• Managed care organizations, as payers

If you run a non-medical home care agency serving Medicaid clients in Texas, you are a program provider. If you also support self-directing clients, the FMSA and CDS employer rules become relevant, and the compliance consequences for CDS differ, as noted above.

As everywhere, the requirement follows Medicaid funding. Private pay visits are not covered by the federal EVV requirement, though your Texas Medicaid visits are.

TMHP states that EVV is required for Medicaid personal care services effective 1 January 2021, and for Medicaid home health care services effective 1 January 2024.

Those are each a year later than the federal deadlines of 1 January 2020 and 1 January 2023. That is not a contradiction. States able to show a good faith effort and unavoidable delays could obtain a one-year extension, and Texas is a clear example of the pattern described on our Cures Act page.

Both dates are well in the past. The live question in Texas is not whether EVV applies but whether your usage score is holding above 80%.

If you want to use software other than the state-provided system, here is what the handbook describes.

Approval sits with TMHP, overseeing the process on behalf of HHSC. You begin by submitting an electronic EVV Proprietary System Request Form signed by an authorized representative.

There are two onboarding paths. A standard path for new systems or functionality that has not been approved before, and an expedited path for systems already fully approved and operational. Requests are reviewed first come, first served by the date the form is received.

Approval brings continuing obligations, which are the part agencies tend to underestimate. Approved operators must maintain compliance, notify HHSC or TMHP of system non-compliance within two business days, provide state and MCO staff with cost-free access to the system, conduct annual user training and provide attestation of it, and submit to EVV compliance reviews and audits.

When policy changes require system updates, HHSC indicates it typically provides a minimum of 90 days.

Two questions worth putting to any vendor claiming Texas support: whether their system is already an approved EVV Proprietary System in Texas, and whether they will meet the ongoing obligations above, including giving state and MCO staff access at no cost. Those commitments fall on the system operator, not only on you.

Things we could not pin down from an official source well enough to publish. HHSC and TMHP can answer all of them:

• The full list of covered programs and services. Texas periodically adds services requiring an EVV visit, and we are not going to publish a service-code list we cannot keep current. Confirm your specific services with HHSC or your MCO.
• Exactly how the EVV Usage Score is calculated. We can tell you the threshold is 80% per quarter and that it is reviewed after visit maintenance closes. The precise formula is set out in HHSC's handbook and is worth reading in full if you are near the line.
• Whether the state-provided system carries any cost to you. HHSC provides it and does not reimburse proprietary systems, but we did not find a direct statement of provider cost for the state system itself, so we are not asserting one.

• HHSC EVV Policy Handbook, the authoritative document, including section 11000 on compliance reviews and section 5000 on proprietary systems
• HHSC EVV pages: hhs.texas.gov EVV
• TMHP EVV: tmhp.com/topics/evv, or email EVV@tmhp.com
• TMHP Contact Center: 800-925-9126, option 6
• LTC Help Desk: 800-626-4117, option 4
• State EVV system vendor, HHAeXchange: 833-430-1307
• Your managed care organizations, individually, since they conduct compliance reviews as payers