Electronic Visit Verification (EVV) in Maine

All states: EVV requirements map

Maine EVV at a glance

Last verified against state sources: 2026-10-08.

How does EVV work in Maine?

Maine uses an open EVV model. The Office of MaineCare Services gives providers two choices: use the state EVV system, which is Sandata and costs the provider nothing, or use an alternate EVV system of their own. Either way, visit data ends up in the Sandata Aggregator, which exchanges files with MIHMS, the MaineCare claims system run by Gainwell Technologies.

The state system includes the Sandata EVV Portal, the Sandata Mobile Connect app and telephonic visit verification. Agencies that want their own software can use it once the vendor is certified by Sandata. Here is what the state EVV questions and answers say about that route:

• There is no integration fee, but the provider pays for its own system and for any changes needed to make it compliant.
• Plan a minimum of eight weeks for the certification process.
• A vendor that is not yet approved for Maine starts the process by writing to MEAltEVV@sandata.com.

The only public list of alternate vendors we found is in that state document, dated June 5, 2023. Sandata keeps the current approved list and does not publish it, so ask Sandata or your vendor for today's status instead of relying on the 2023 list. For general EVV questions, Gainwell Provider Services is at 1-866-690-5585, option 3.

Which MaineCare services require EVV?

EVV applies to in-home personal care and home health services billed to MaineCare. State guidance gives January 1, 2021 as the date EVV was required for personal care services, and the home health rule (Section 40) took effect January 1, 2023. Hospice is not subject to EVV.

The state lists EVV services by section of the MaineCare Benefits Manual and publishes an EVV service code list. In plain terms:

• Sections 12, 19 and 96: personal care (personal support), attendant services, in-home respite and private duty nursing. Under Section 96, Private Duty Nursing Level IX, care coordination and skills training are exempt.
• Sections 18, 20, 21 and 29 (waiver services): home support, plus personal care under Section 20 and respite under Section 29.
• Section 28: services delivered one to one in the member's home that include personal care or skill building.
• Section 40: home health services.

Each visit record must carry the six data elements in the federal 21st Century Cures Act: the type of service, who received it, who delivered it, the date, the location, and the start and end times.

A few situations fall outside EVV. Live-in caregivers bill with place of service 40, which is not an EVV place of service. Telehealth visits (place of service 02 or 10 with the GT modifier) are excluded. Section 28 services that are not one to one in the home, or that have no personal care or skill building part (assessment work, for example), also bill place of service 40.

Hospice (Section 43) deserves a clear answer because older state documents still point the other way. The state adopted a hospice EVV provision in early 2024, the Legislature then passed a law on the subject, and the department repealed the provision by a rule adopted October 30, 2024, retroactive to June 30, 2024. The October 2023 code list still shows hospice codes, but it predates the repeal.

Does Maine deny MaineCare claims without a verified EVV visit?

Yes. A claim that carries an EVV service code and an EVV place of service needs a matching verified visit record. If there is none, the claim pends and, if no verified visit arrives, it denies. The state tells providers not to alter a claim while it is pending.

• Home health (Section 40): for dates of service beginning January 1, 2023, a claim with no verified matching EVV record pends for up to 30 days and then denies. A softer pend with a three-day recycle period applied from July 1, 2022. Home health providers also need a certification number before they submit EVV visit records.
• Personal care and waiver services: the same pend and deny check applies. We did not find a state source that gives the date this check began for personal care, or one that says how long these claims pend before they deny. Ask Gainwell Provider Services if you need either answer.

Place of service matters here. The check looks at both the service code and the place of service, so a visit billed with the wrong place of service can pend when it should not, or skip a check it should have met. In practice the agencies that stay paid are the ones that clear visit exceptions every day, so the verified visit is already in the aggregator when the claim goes out.

MaineCare long term services are paid fee for service, so there are no separate managed care plan EVV rules to track.

What is changing next for Maine EVV?

This is a billing system and portal change, not a change to EVV policy. We did not find any announced change to the EVV rules, to Sandata as the state system, or to the open model.

The state planned a MIHMS data freeze from Friday, October 2, 2026 at 8:00 PM to Monday, October 12, 2026 at 8:00 AM. According to the state's data freeze questions and answers:

• Visit capture in Sandata and in alternate EVV systems stays available during the freeze for known members with approved prior authorizations.
• New members, authorizations and providers are current in Sandata only as of October 1.
• File exchanges between Sandata and MIHMS were scheduled to resume on October 10 and 11, with all updates visible by October 12 at 8:00 AM.

If you added clients or received new authorizations in early October, confirm they appear correctly in your EVV system before you bill those visits.

On hospice, no EVV start date has been announced. State law now allows the department to adopt hospice EVV rules only as major substantive rules, which is a longer rulemaking path.

Maine EVV sources

• Office of MaineCare Services: Electronic Visit Verification
• Maine DHHS: EVV questions and answers (June 5, 2023)
• Maine DHHS: EVV service codes (October 2023)
• Sandata: Maine vendor solutions (alternate EVV interface)
• MaineCare provider bulletin: EVV place of service reminders (September 26, 2022)
• MaineCare provider bulletin: home health and hospice providers, EVV (January 27, 2023)
• Maine DHHS rulemaking: adoption notice, Section 43 Hospice (October 30, 2024)
• Maine DHHS: MIHMS data freeze provider FAQ (September 2026)
• MaineCare provider bulletin: MIHMS upgrade, October payment cycle changes and system access

Related reading

• EVV Software Compatible with Sandata Aggregator
• EVV Aggregators Explained: A Simple Guide for Home Care Providers
• The Benefits of Using 3rd-Party EVV Software
• EVV Software Demo Checklist: What to Ask and Test Before You Buy
• What is EVV Software?
• EVV requirements for every state (map)

Other states that use Sandata

California, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Indiana, Massachusetts, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Wisconsin. See every state on the EVV requirements map.

Page history

• October 8, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides EVV software for Medicaid home care agencies. If you would like to talk through Maine's requirements, contact Ankota or read more about Ankota's EVV software.