Electronic Visit Verification (EVV) in South Dakota

All states: EVV requirements map

South Dakota EVV at a glance

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

How does EVV work in South Dakota?

South Dakota chose the Open Vendor Model for EVV. The state offers a free EVV system, and an agency can use it or use its own EVV software instead. Which free system applies, and what a third-party system has to do, depends on the program you bill.

• HOPE Waiver and State Plan Personal Care: the state system is Therap, offered at no cost. EVV has applied since January 1, 2021. An agency that wants to use another system files the Provider Request for Approval for Alternative IT System for EVV form, and data collected outside Therap is uploaded into Therap.
• Home health and private duty nursing: Therap is offered at no cost, or the agency can pay for a third-party system that connects to the Therap Aggregator. EVV has applied to these services for dates of service from January 1, 2024.
• ADLS Waiver and Family Support 360 self-directed personal care: the state system is FOCoS, offered at no cost, and claims are submitted electronically through it. EVV has applied since January 1, 2021. An alternative system is allowed with the same approval form.

The state's EVV rules call for the six standard visit data elements. Live-in caregivers are not exempt. CHOICES waiver services are not on the state's list of programs subject to EVV, according to the South Dakota Medicaid EVV billing manual.

Which South Dakota services have to use the Therap Aggregator?

Only home health and private duty nursing. The Therap Aggregator is a central database that collects, validates and stores EVV data, and the state manual calls it mandatory for collecting and submitting EVV data to the Medicaid claims system (MMIS) for these two services. Aggregator submission took effect December 31, 2023, for services delivered from January 1, 2024.

For other programs, the EVV billing manual says the Aggregator is not required for HOPE Waiver, ADLS Waiver or Family Support 360 Waiver services at this time. That wording comes from the manual dated February 2024, which is still the version posted. HOPE providers keep sending EVV through Therap's EVV platform or by uploading third-party data into Therap. The manual's question and answer on this point does not name State Plan Personal Care either way. It requires the Aggregator only for home health and private duty nursing.

If you use your own EVV software for home health or private duty nursing, the state expects:

• A connection from your system to the Therap Aggregator that follows Therap's published data requirements.
• Visit updates sent in near real time, and within 15 days of the date of service.
• Signed Therap Trading Partner Agreements from both the provider and the vendor.
• A first contact with the state at programintegrity@state.sd.us to start the process.

We did not find a published list of approved third-party EVV vendors for South Dakota, so ask the state or Therap whether a vendor is already connected before you sign with one.

Does South Dakota deny Medicaid claims without EVV?

It depends on the program, and the state sources do not spell out one clear denial rule. For home health and private duty nursing, the manuals say EVV data in the Therap Aggregator is sent to MMIS for use in claim adjudication. For HOPE Waiver providers, the rules rest on a 75 percent compliance floor, audit recoupment, and older state guidance about a claim denial when EVV data is missing from Therap.

What is confirmed for HOPE Waiver providers:

• 75 percent rule: the LTSS Provider Policy Manual (effective February 10, 2026) requires compliant EVV for no less than 75 percent of EVV services. Manual entry is a last resort, is capped at 25 percent, and does not count as compliant.
• Audit recoupment: services that are not documented are subject to recoupment on audit.
• Service authorization: the authorization has to be acknowledged in Therap before the service is delivered, or the service is denied.
• Older denial guidance: a December 2020 state question and answer document says Medicaid claims for EVV services deny with reason 377 unless EVV data is present in Therap and the prior authorization number matches. That document is still posted, but it is from 2020, so confirm that claims still process this way.

For State Plan Personal Care, EVV collection is required, but we did not find a state source that describes claim denial specific to that benefit. For ADLS, providers must use EVV to substantiate all personal attendant claims, and the manual does not describe an automatic denial. For Family Support 360, the billing manual has no EVV denial rule.

What is changing next for South Dakota EVV?

We found no upcoming EVV change for South Dakota as of our last check. The state has not announced a new vendor, a new aggregator, or a date for extending the Therap Aggregator to HOPE, ADLS or Family Support 360. The South Dakota Medicaid provider communications list for 2026 has no notice with EVV in its title.

One thing to keep in mind is the age of the main source. The EVV billing manual has not been reissued since February 2024, and its statement that the Aggregator is not required for other programs uses the words "at this time". That leaves room for change, but no change has been published. If you bill HOPE, ADLS or Family Support 360 services, it is worth checking the provider communications page a few times a year.

South Dakota EVV sources

• South Dakota Medicaid billing manual: Electronic Visit Verification (February 2024)
• South Dakota Medicaid billing manual: Home Health (updated December 2025)
• South Dakota Medicaid billing manual: Personal Care Services (updated March 2026)
• South Dakota DHS: LTSS Provider Policy Manual (effective February 10, 2026)
• South Dakota DHS: Therap questions and answers (December 23, 2020)
• South Dakota DHS: LTSS EVV upload guidance
• South Dakota Medicaid billing manual: Assistive Daily Living Services (updated April 2025)
• South Dakota Medicaid billing manual: Family Support 360 (October 2025)
• South Dakota Medicaid: provider communications

Related reading

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

Other states that use Therap

Alaska, Kentucky, North Dakota. 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 South Dakota's requirements, contact Ankota or read more about Ankota's EVV software.