Electronic Visit Verification (EVV) in Texas

All states: EVV requirements map

Texas EVV at a glance

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

How does EVV work in Texas?

Texas gives each agency two choices. You can use the state-provided EVV system, HHAeXchange, at no cost, or you can use a proprietary EVV system that the state has approved for your agency. Either way, visit data flows to the TMHP EVV Aggregator, which is run by the Texas Medicaid & Healthcare Partnership (TMHP). An agency has to use a single EVV system at a time.

HHAeXchange has been the single state-funded system since October 1, 2023. It replaced the two vendor systems the state used before that date. The Texas Health and Human Services Commission (HHSC) sets the rules in its EVV Policy Handbook, and TMHP manages the aggregator, claims matching and the EVV Portal.

EVV has been required for Medicaid personal care services since January 1, 2021, and for home health care services since January 1, 2024. The handbook lists the covered services program by program. For home care agencies, that includes:

• Personal attendant services in Primary Home Care, Community Attendant Services and Family Care.
• Personal care and Community First Choice services in STAR+PLUS, STAR+PLUS HCBS, STAR Kids and STAR Health.
• In-home respite, nursing, occupational therapy and physical therapy in the programs where the handbook lists them.
• Waiver services in programs such as CLASS, DBMD, HCS and TxHmL, where the same statewide rules apply.

Many of these services require EVV only when they are delivered in the member's own home or family home, and the definition of own home varies by program. In the Consumer Directed Services (CDS) option, the financial management services agency (FMSA) selects the EVV system and the CDS employer uses that system.

Can a Texas agency use its own EVV software instead of HHAeXchange?

Yes, but only through an approval process. A program provider or FMSA that wants to use its own EVV software has to become what Texas calls a Proprietary System Operator (PSO) and get written approval from TMHP before using the system. An agency that is not approved as a PSO must use HHAeXchange.

Approval attaches to the agency together with its system, not to a software vendor alone. Here is what the state requires:

• The system is purchased or developed by the provider or FMSA and exchanges data with the TMHP EVV Aggregator.
• TMHP runs an Operational Readiness Review, and a 100 percent score is needed on each required method.
• There is a standard path for systems that have not been approved before and an expedited path for systems that are already approved and operating.
• The PSO pays all of the system's costs and gives up the free state system.
• An FMSA that operates a proprietary system needs one that supports the CDS model, and it may not charge the CDS employer, the service provider or the member for clock-in or clock-out methods.

TMHP publishes a list of approved EVV proprietary systems. The list dated September 1, 2026 shows 12 systems, and two of them are marked as supporting Consumer Directed Services. The list changes over time, so check the current version before you make a software decision.

Does Texas deny Medicaid claims without a matching EVV visit?

Yes. Texas payers must not pay a claim for an EVV-required service unless it matches an accepted EVV visit in the TMHP EVV Aggregator. Claims that do not match are denied, and payments can be recouped later. The same match rules apply to fee-for-service and managed care payers.

A claim is checked against the visit on these items:

• The member's Medicaid ID
• The date of the visit
• The provider's NPI or API and, where it applies, the Texas EVV Service Provider ID
• The HCPCS code and modifiers
• The units billed

A mismatch on any one of these leads to a denial. For some programs and services the units are not expected to match, and the claim can pay if everything else lines up. A claim that does match can still be denied for reasons that have nothing to do with EVV.

Two more rules matter day to day. First, do not submit a claim until the visit shows as accepted in the aggregator. Second, do not count on a grace period. As of January 30, 2026, HHSC no longer grants compliance grace periods. It can temporarily bypass claims matching in only three cases: a verified EVV system issue, a verified state system issue, or a natural disaster or public health emergency. EVV must still be used during a bypass, and recoupment remains possible afterward.

HHSC may allow a practice period before EVV starts for a new service or program, and claims pay without a match during that period. In practice, a visit that was delivered but never reached accepted status is a visit that does not get paid, which is why agencies that review visit exceptions every day have fewer denials than those that wait until billing time.

What is changing next for Texas EVV?

The main scheduled change is a tighter limit on alternative devices, one of the approved ways to clock in and clock out. HHSC caps the share of visits that can be recorded with an alternative device at 50 percent for state fiscal year 2027, which began September 1, 2026. The handbook schedules that cap to fall to 25 percent on September 1, 2027 and to 5 percent on September 1, 2028. Agencies that lean on alternative devices should plan now to move visits to other approved methods.

For agencies that want to move to a proprietary system, TMHP posts an onboarding schedule and marks it as subject to change. When we last checked, it listed a standard-path session with an earliest go-live in mid December 2026 and expedited sessions with earliest go-live dates in early 2027. Treat those as tentative and check the TMHP proprietary systems page for the current schedule.

We did not find any other upcoming change to the Texas EVV handbook as of our last check. The most recent revision took effect January 30, 2026. We also did not review bulletins from individual managed care plans, so check with your plan for any plan-specific EVV rules.

Texas EVV sources

• Texas HHSC: Electronic Visit Verification (EVV)
• HHSC EVV Policy Handbook: 4000 EVV System Setup
• HHSC EVV Policy Handbook: 5000 EVV Proprietary System
• HHSC EVV Policy Handbook: 7000 Clock In and Clock Out Methods
• HHSC EVV Policy Handbook: 13000 EVV Claims
• HHSC: EVV Policy Handbook revisions (January 2026)
• TMHP: EVV Proprietary Systems
• TMHP: Approved EVV Proprietary Systems list
• HHSC provider news (July 17, 2026): services added requiring an EVV visit for FMSAs and CDS employers

Related reading

• EVV Aggregators Explained: A Simple Guide for Home Care Providers
• Medicaid Waiver Billing Software: Avoiding Denials in HCBS
• What is EVV Software?
• Ensuring Compliance with EVV-Compliant Mobile Apps
• EVV Electronic Visit Verification Guide
• EVV requirements for every state (map)

Other states that use HHAeXchange

Illinois, Michigan, Minnesota, Mississippi, New Jersey, West Virginia. 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 Texas's requirements, contact Ankota or read more about Ankota's EVV software.