Understanding Missouri’s EVV Compliance: What Every Home Care Provider Needs to Know

Electronic Visit Verification (EVV) is one of the most important compliance requirements for Missouri home care providers. Whether you operate a Consumer Directed Services (CDS) agency or an In-Home Services (IHS) agency, understanding how EVV works and how to stay compliant is essential to maintaining your DHSS approval and Medicaid reimbursement.

This guide breaks down what EVV is, why it’s required, which services it applies to, and how to ensure your agency meets Missouri’s standards under 13 CSR 70 3.320.

What Is EVV (Electronic Visit Verification)?

EVV is a federally mandated system that electronically records when and where a caregiver provides services to a client in their home.

It captures six key data points for each visit:

1. Type of service provided

2. Individual receiving the service

3. Date of the service

4. Location of the service delivery

5. Individual providing the service

6. Start and end time of the service

Missouri requires all providers delivering personal care or home health services funded by Medicaid to use an EVV system that meets both federal 21st Century Cures Act standards and state DHSS and MO HealthNet requirements.

Why EVV Matters for Missouri Home Care Providers

The purpose of EVV is to ensure accountability, prevent fraud, and improve transparency in home-based care. For your agency, EVV compliance:

✅ Protects reimbursement because claims without valid EVV data may be denied✅ Reduces audit risk by keeping accurate, real-time records✅ Builds client and state trust in the integrity of your services✅ Simplifies payroll and scheduling when integrated with your agency software

Failure to comply with EVV rules can lead to payment delays, audits, or suspension from the MO HealthNet program.

Who Must Use EVV in Missouri

EVV is required for the following Medicaid-funded services:

• Personal Care (IHS and CDS)

• Homemaker Services (if part of an IHS care plan)

• Advanced Personal Care (APC)

EVV is not required for:

• Respite services

• Nursing visits

• Adult Day Care services

• Services delivered in group settings (non-individualized care)

Understanding these distinctions helps your agency avoid both over-reporting and compliance gaps.

Missouri’s EVV Policy: What the Law Says (13 CSR 70 3.320)

Under Missouri Code 13 CSR 70 3.320, providers must:

• Use an EVV system that records the required six data points

• Maintain EVV data for at least seven years for audit purposes

• Ensure staff receive training on EVV use and reporting procedures

• Report any system errors or data discrepancies to MO HealthNet

• Keep policies and procedures that explain how EVV is implemented, monitored, and maintained

Providers are also responsible for verifying that the system integrates properly with MO HealthNet billing systems and accurately reflects billed time and services.

How to Choose an EVV System

When selecting an EVV solution, consider:

• DHSS and MO HealthNet approval: Use only systems authorized for Missouri providers

• User-friendly interface: Aides should be able to clock in and out easily using a mobile app or landline

• GPS or location verification: Must record service location accurately

• Data security: The system must protect client and worker information in compliance with HIPAA

• Reporting features: Choose a platform that generates compliance and billing reports to simplify audits

Many agencies use EVV platforms like Sandata, HHAeXchange, or CareSmartz360, depending on their program model and size.

How to Stay in Compliance

To remain compliant with Missouri’s EVV requirements, agencies should:

✅ Include EVV procedures in their official policy and procedures manual✅ Provide initial and ongoing staff training on EVV usage and troubleshooting✅ Conduct monthly EVV audits to ensure data matches billing✅ Document all system outages, corrections, and exceptions✅ Keep communication open with MO HealthNet for updates or policy changes

By maintaining accurate and consistent EVV documentation, your agency will pass audits confidently and protect its Medicaid participation status.

Common EVV Mistakes (and How to Avoid Them)

1. Inaccurate time entries: Make sure aides clock in and out on time and from the correct location

2. Untrained staff: Provide step-by-step EVV training during onboarding

3. Incomplete records: Regularly check reports for missing data fields

4. Failure to update policies: Review and update your EVV policy annually

5. Ignoring alerts or errors: Address system flags immediately to prevent claim denials

Consistency and oversight are key to avoiding costly errors or compliance issues.

EVV compliance isn’t just a technical requirement — it’s part of your agency’s commitment to transparency, quality, and client safety. By understanding the rules, training your team, and maintaining proper documentation, you’ll keep your agency compliant and credible.

If you need help developing or updating your EVV policy and procedures to meet Missouri’s DHSS standards, professional assistance can save you time and stress.

👉 Book a consultation and get your compliant EVV policy and business documentation started today.