Electronic Visit Verification (EVV) in New York
All states: EVV requirements map
In short: Open model. Any compliant EVV system can submit to the state's eMedNY aggregator. The state does not automatically deny unmatched claims, but some plans add their own checks. Change ahead: Fidelis Care is scheduled to start enforcing its EVV billing checks, and MetroPlusHealth to require EVV data through HHAeXchange, on November 1, 2026.
New York EVV at a glance
| EVV model | Open (Choice Model). Agencies and fiscal intermediaries pick and pay for their own EVV system. |
|---|---|
| State EVV system | None. New York does not provide a visit capture system. |
| Aggregator | eMedNY (the NYS EVV Data Aggregator) |
| Can I use my own EVV vendor? | Yes. The state does not approve, certify or list EVV vendors. |
| Are claims denied without EVV? | Not automatically by the state. Compliance reviews and audits are possible. |
| Managed care | Many plans require visits and billing through HHAeXchange. Plan rules vary, so check each plan. |
| In effect since | Personal care: January 1, 2021. Home health: January 1, 2023. |
Last verified against state sources: 2026-10-08.
How does EVV work in New York?
New York uses an open EVV model that the state calls the Choice Model. There is no state-run EVV system. Each provider or fiscal intermediary selects and pays for its own EVV system, and that system sends visit data to eMedNY, the state's EVV data aggregator. The New York State Department of Health (NYSDOH) does not endorse, approve or certify EVV systems, and it says it will not publish a vendor list.
Any system can be used if it meets the federal 21st Century Cures Act requirements and can submit EVV data to eMedNY. A third party may submit data on a provider's behalf. Providers enroll in eMedNY, complete an EVV attestation each year, and send visit data separately from their claims.
EVV has been required for Medicaid personal care services since January 1, 2021 and for home health care services since January 1, 2023. It applies in both fee-for-service and managed care. The details that matter most day to day:
- Which services: personal care and home health services that begin or end in the member's home and involve help with daily living activities. NYSDOH publishes a list of applicable billing codes, which includes Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waiver codes.
- What is captured: the six federal data elements. GPS is not required. The start and end locations are reported as Home or Community.
- When to submit: NYSDOH recommends sending EVV data after the service and before the claim.
- What is not covered: sole practitioner private duty nurses are not required to submit EVV, under a NYSDOH notice dated November 13, 2023. Community Habilitation delivered entirely in the community is also outside EVV.
The Consumer Directed Personal Assistance Program (CDPAP) works differently in practice. Public Partnerships LLC (PPL) has been the only authorized CDPAP fiscal intermediary since April 1, 2025, and it offers personal assistants two EVV methods: the Time4Care mobile app and a telephone line.
Does New York deny Medicaid claims without a matching EVV record?
Not automatically. The NYSDOH EVV FAQ dated September 15, 2026 says there is currently no automatic claim denial or pend when a claim does not match an EVV transaction. That is the state rule, and it covers the state's own claims processing. It does not mean missing EVV carries no risk, and it does not describe what an individual managed care plan does.
Important: Keep state rules and plan rules separate. The state does not automatically deny or pend an unmatched claim, but some managed care plans set their own billing edits and their own dates. A claim that would pass the state's check can still be held up by a plan.
A claim still needs a matching EVV transaction to count as compliant. The state matches EVV records to claims using the provider's NPI or MMIS ID. NYSDOH may run compliance reviews, and it can refer a provider to the Office of the Medicaid Inspector General (OMIG) for audit and recovery of overpayments.
The exposure is real. A State Comptroller audit issued November 13, 2024 found $14.5 billion paid for 82 million personal care services, and $97.6 million paid for more than 400,000 home health services, with no matching EVV record. The audit recommended controls to prevent payment of claims that lack EVV records. In practice, a visit that was delivered but never reached eMedNY is a payment that could be questioned later.
What do New York managed care plans require for EVV?
Many New York managed care and managed long term care plans require providers to send visits and billing through HHAeXchange. This is a plan requirement, not a state one, and it sits on top of the state's Choice Model. Providers on these plans can generally use HHAeXchange's free EVV tools or keep their own EVV system and connect it to HHAeXchange by EDI.
HHAeXchange lists New York provider hubs for Fidelis Care, Healthfirst, VNS Health, Elderplan, Aetna Better Health of New York, CenterLight PACE, ElderServe, Molina, Senior Whole Health and UnitedHealthcare Community Plan, with VillageCareMAX in implementation.
Fidelis Care is the plan with the most detail published. It requires network providers to submit visits and billing through HHAeXchange, and it set a claim denial date of February 14, 2022 for billing outside that platform. Its published 2026 schedule lists audit and monitoring from June 15, 2026 and billing edits as soft edits from August 1, 2026.
We did not find published claim edit dates for the other plans. If you bill any of them for personal care or home health services, ask the plan directly what it checks before it pays and when those checks apply.
HHAeXchange also reports that plans must send NYSDOH a quarterly EVV compliance report that compares paid claims with EVV visit records, starting with the quarter of April 1 to June 30, 2026. We did not find a NYSDOH document that describes this reporting, so treat the detail as coming from the plans' contractor.
What is changing next for New York EVV?
We found no upcoming change to the state's own rules as of our last check. The nearest dated changes come from two managed care plans, and both are scheduled for November 1, 2026. These are the plans' published schedules, so confirm the date with the plan before you rely on it.
- Fidelis Care: the plan's schedule moves its HHAeXchange billing edits from soft edits to enforcement on November 1, 2026. We did not find the exact rule that will be enforced, so ask Fidelis Care or HHAeXchange what will cause a claim to be stopped.
- MetroPlusHealth: the plan is scheduled to require all network providers to submit EVV data through HHAeXchange from November 1, 2026. Providers can use HHAeXchange's own tools or a third-party EVV system that connects to it.
For CDPAP, we did not find any future dated EVV change.
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Who to ask about New York EVV
Questions about New York EVV rules are best put to the state. Start with NYSDOH: Electronic Visit Verification FAQs (September 15, 2026). The state lists EVVHelp@health.ny.gov for EVV questions.
New York EVV sources
- NYSDOH: Electronic Visit Verification FAQs (September 15, 2026)
- NYSDOH: EVV applicable billing codes
- NYSDOH: EVV notice on private duty nursing (November 13, 2023)
- NYS Comptroller: audit of provider compliance with the EVV program (November 13, 2024)
- NYSDOH: MLTC Policy 25.03 on the statewide CDPAP fiscal intermediary
- PPL: CDPAP Electronic Visit Verification
- HHAeXchange: New York EVV compliance information center
- HHAeXchange: Fidelis Care provider information
- HHAeXchange: MetroPlusHealth provider information
Related reading
- Best EVV Software Compatible with HHA Exchange
- EVV Aggregators Explained: A Simple Guide for Home Care Providers
- The Benefits of Using 3rd-Party EVV Software
- Essential EVV Software Features: A Checklist for Home Care Agencies
- What is EVV Software?
- 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 EVV software for Medicaid home care agencies. If you would like to talk through New York's requirements, contact Ankota or read more about Ankota's EVV software.
Ms. Donna Frescatore
New York Department of Health
Empire State Plaza, Corning Tower, Room 1466
Albany, NY 12237