Electronic Visit Verification (EVV) in Maryland
All states: EVV requirements map
In short: Closed model. Agencies must record visits in the state's own EVV app or phone line, and services not recorded there are not paid.
Maryland EVV at a glance
| EVV model | Closed. Agencies use the state's own EVV system. |
|---|---|
| State EVV system | LTSSMaryland EVV (mobile app, plus the ISAS phone line) |
| Aggregator | No separate aggregator. LTSSMaryland builds the claims and sends them to MMIS. |
| Can I use my own EVV vendor? | No, not for clocking visits. Agency staff must use the state's EVV method. |
| Are services paid without EVV? | No. EVV services are reimbursed only if recorded in the approved EVV system. |
| Self-directed services | Recorded in the EVV system of the participant's FMCS contractor, not the state app. |
| Live-in caregivers | An exemption has been available since July 1, 2023. It must be requested and approved. |
Last verified against state sources: 2026-10-08.
How does EVV work in Maryland?
Maryland uses a closed EVV model. The Maryland Department of Health (MDH) runs its own system, called LTSSMaryland EVV, and agency staff clock in and out there. There is no separate aggregator. LTSSMaryland records the visit, bundles services into claims, and sends those claims to the state's Medicaid claims system (MMIS) each night.
Staff can record a visit in these ways:
- LTSSMaryland EVV mobile app: the state's current preferred method.
- ISAS phone line (IVR): a call to 1-855-4MD-ISAS from the phone number registered for the participant.
- One-time passcode (OTP) device: used where it is needed.
Note: The MDH EVV page still carries a 2024 notice saying all providers would be required to use the mobile app. The state's August 2025 provider guide for Community Options and Community First Choice calls the app the preferred method and says staff without a smartphone may continue to use the phone line. If your agency relies on the phone line, confirm the current rule with the LTSSMaryland Provider Billing Support Office.
For home care agencies, the state's provider guide lists four programs on LTSSMaryland EVV: the Community Options Waiver, Community First Choice (CFC), Community Personal Assistance Services (CPAS) and Increased Community Services (ICS). The EVV services are Personal Assistance, Shared Attendant, Daily Personal Assistance and Daily Shared Attendant Services. Other waiver services, such as home delivered meals, are entered in the same Provider Portal but are not EVV services.
Home health providers and their workers are also required by regulation to use the Department-approved EVV method and system to document time and submit claims. CMS lists Maryland as compliant for home health EVV as of January 1, 2024. For readers who also serve people with developmental disabilities, Personal Supports and 15-minute Respite Care under the Developmental Disabilities Administration (DDA) waiver use LTSSMaryland EVV as well.
Can I use my own EVV software in Maryland?
Not for clocking visits. Maryland regulation (COMAR 10.09.36.03-2) says agency providers and their workers must use the Department-approved EVV method and data management system. Because the state built its own system, there is no list of approved alternate EVV vendors, and we did not find one on any MDH page.
Billing is a separate question. An MDH billing FAQ says third-party software can be set up through the LTSSMaryland help desk so that an agency does not have to key each service by hand. This appears to be a billing upload path and not another way to capture visits, but we could not confirm exactly what it covers. If you want your agency software to exchange data with LTSSMaryland, ask the help desk what is allowed before you plan around it.
Self-directed services work differently. When a participant directs their own care, the worker uses the EVV system of the Financial Management and Counseling Services (FMCS) contractor that the participant selected, and does not use the state's app. That choice belongs to the participant's FMCS arrangement, so it is still not an open choice of EVV vendor.
Does Maryland pay for visits that are not recorded in EVV?
No. Under COMAR 10.09.36.03-2, the Department reimburses EVV services only if they are electronically recorded in the approved EVV system. The service also has to be preauthorized and delivered in person unless the state has authorized otherwise. The one exception is an approved manual process for live-in caregivers who hold an exemption.
The state's provider guide for Community Options and Community First Choice adds several rules that decide whether a visit is paid:
- Exceptions pend. A service with an exception is held until the exception is resolved.
- Missing time has a deadline. A Missing Time Request must be submitted within 30 days of the service date. After that, it is not accepted.
- Overlaps are not paid. Services with overlapping times that are not resolved are not reimbursed.
In practice, a missed clock-in or clock-out is not only a paperwork problem. If it is not corrected within 30 days, the visit can go unpaid. Agencies that review missing time and exceptions every day, instead of at the end of the month, are the ones that keep every delivered visit billable.
Live-in caregivers can be exempted from EVV under a State Plan Amendment that took effect July 1, 2023. The exemption is not automatic. The state's Office of Long Term Services and Supports reviews requests for CFC and CPAS.
What is changing next for Maryland EVV?
We did not find any announced change to Maryland's EVV system, vendor or model as of our last check. The MDH EVV page lists mobile app trainings for agency administrators twice a month through December 16, 2026. That is a training calendar, not a rule change.
One related item is in motion but does not change EVV. The DDA submitted an amendment to its Community Pathways Waiver to CMS on July 1, 2026, and the DDA says it remains under review. It deals with self-directed budgets and rates. If you serve DDA participants, watch the DDA waiver changes page for the final terms.
Get notified when Maryland EVV rules change
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Who to ask about Maryland EVV
Questions about Maryland EVV rules are best put to the state. Start with Maryland Department of Health: LTSSMaryland EVV.
Maryland EVV sources
- Maryland Department of Health: LTSSMaryland EVV
- COMAR 10.09.36.03-2: Electronic Visit Verification (via Cornell LII)
- COMAR 10.09.04.07: Home health payment conditions (via Cornell LII)
- MDH: LTSSMaryland Provider Portal Reference and User Guide for CO and CFC (version 2.5, August 2025)
- MDH: FAQ for LTSSMaryland billing systems
- CMS: Maryland State Plan Amendment MD-23-0012 (Community First Choice)
- CMS: EVV compliance status for home health care services by state
- MDH: DDA EVV Policy Guide (September 25, 2023)
- Maryland DDA: Waiver changes
Related reading
- What is EVV Software?
- EVV Electronic Visit Verification Guide
- EVV Aggregators Explained: A Simple Guide for Home Care Providers
- Ensuring Compliance with EVV-Compliant Mobile Apps
- EVV requirements for every state (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 home care software for agencies that serve Medicaid and private pay clients. If you would like to talk through Maryland's requirements, contact Ankota or read more about Ankota's EVV software.
Mr. Dennis R. Schrader
Maryland Department of Health
201 West Preston Street, Room 525
Baltimore, MD 21201