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Ankota offers end-to-end solutions for managing care delivery for older or disabled people in their homes and in day facilities. Additionally, some of Ankota's solutions can be unbundled modular components for companies that have home-grown or best of breed components but need additional add on capabilities.

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    Home Care, Day Services and Disability Services will continue to be among the most important industries worldwide for the next 2 to 3 decades. The resources provided here are designed to help you learn and grow. Thanks for being home care heroes and day service stars

      About Us

      Ankota creates software for organizations that keep older and disabled people living at home. Our primary products are software for Home Care, Electronic Visit Verification, Adult Day Services, and Long Term Supports and Services (LTSS) for people with Intellectual and Developmental Disabilities. We also support other players in this ecosystem like PACE programs, Area Agencies on Aging (AAAs), Centers for Independent Living (CILs) and more

          Electronic Visit Verification (EVV) in Virginia

          Click for the Ultimate Guide to EVV

          Electronic Visit Verification (EVV) in Virginia

          All states: EVV requirements map

          In short: Provider choice with no state EVV system. EVV data is sent on the claim, and claims without it are denied. The live-in caregiver exemption ended October 1, 2026. Change ahead: The live-in caregiver EVV exemption ended October 1, 2026. DMAS has said there will be no compliance penalties before January 1, 2027, and penalty terms are not yet published.

          Virginia EVV at a glance

          EVV modelOpen (provider choice) for agency-directed services. Agencies pick their own EVV software.
          State EVV systemNone. DMAS does not provide an EVV system and does not approve or certify vendors.
          AggregatorNo statewide aggregator. EVV data is sent on the claim and kept in the DMAS Medicaid Enterprise System (MES).
          Can I use my own EVV vendor?Yes. The system must meet the state EVV regulation and DMAS and health plan reporting requirements.
          Are claims denied without EVV?Yes. Personal care, respite and companion since September 1, 2020, and home health since January 1, 2024.
          Managed careHumana Healthy Horizons requires HHAeXchange. Anthem HealthKeepers Plus requires the Netsmart EVV clearinghouse.
          Live-in caregiversNo longer exempt as of October 1, 2026.

          Last verified against state sources: 2026-10-07.

          How does EVV work in Virginia?

          Virginia is a provider choice state for agency-directed services. There is no state-run EVV system and no statewide aggregator. Each agency buys its own EVV system, and the EVV information travels on the electronic claim itself, where it is stored in the Medicaid Enterprise System (MES) run by the Department of Medical Assistance Services (DMAS).

          DMAS states that it does not and will not approve EVV vendor systems, so there is no state vendor list to check. An agency can select any system that meets the state EVV regulation (12VAC30-60-65) and the reporting requirements of DMAS and the health plans it bills. The agency pays for its own system.

          EVV applies to these agency-directed services:

          • Personal care (T1019), respite (T1005) and companion (S5135), billed on the 837P claim.
          • Home health, billed on the 837I claim under revenue codes 0550, 0551, 0559, 0571, 0424, 0421, 0434, 0431, 0444 and 0441. Hospice and private duty nursing are excluded.

          The regulation requires the six data elements set by the federal 21st Century Cures Act, and agencies must keep EVV records for at least six years. Some services are exempt because of where they are delivered: services inside settings licensed by the Department of Behavioral Health and Developmental Services (such as group homes, sponsored residential and supervised or supported living), the REACH program, and school services under an IEP. These are billed with the UB modifier.

          Consumer-directed services work differently. There, the Fiscal/Employer Agent (Consumer Direct Care Network or Public Partnerships LLC) supplies the mobile app and phone line that attendants use, so an agency's own software is not part of that process.

          Does Virginia deny Medicaid claims without EVV data?

          Yes. DMAS requires EVV information before it pays a claim for an EVV-required service, and a claim that is missing the EVV data is denied. This has applied to agency-directed personal care, respite and companion services for dates of service on or after September 1, 2020, and to home health since January 1, 2024.

          • September 1, 2020: EVV information became required for payment of agency-directed personal care (T1019), respite (T1005) and companion (S5135) claims.
          • July 1, 2023: soft edits began for home health. Claims were still paid, with EVV errors noted.
          • January 1, 2024: soft edits ended for home health. Claims with EVV errors are denied.

          Because the EVV data rides on the claim, these services have to be billed electronically. DMAS does not accept paper claims or direct data entry (DDE) claims for agency-directed personal care, respite and companion, or for home health dates of service from January 1, 2024. For home health, only one service location is required on the 837I.

          In practice, a Virginia claim is only as good as the visit record behind it. Agencies that review visit exceptions every day, before billing, avoid finding the problem later as a denial.

          Do Virginia Medicaid managed care plans have their own EVV rules?

          Two of them do. Virginia has no statewide aggregator, but Humana Healthy Horizons and Anthem HealthKeepers Plus each require providers to send EVV data through a specific gateway. These are health plan requirements, not DMAS requirements, and they apply only to that plan's members.

          • Humana Healthy Horizons in Virginia: all EVV claims must be submitted through HHAeXchange. EVV claims for dates of service on or after October 29, 2025 that are not submitted through HHAeXchange are denied, and Humana stopped accepting EVV claims through Availity after October 28, 2025. Providers can use the HHAeXchange tool that Humana sponsors at no cost, or another EVV vendor of their choice that is fully integrated with HHAeXchange. Humana uses payer ID 61150 for EVV claims and keeps 61101 for claims that do not involve EVV.
          • Anthem HealthKeepers Plus: providers submit through the Netsmart EVV clearinghouse. Agencies that use a different EVV vendor connect that vendor to Netsmart.

          We did not find a required EVV gateway for Sentara Health Plans, Aetna Better Health of Virginia or UnitedHealthcare Community Plan. If you bill those plans, confirm their current EVV submission rules with each plan's provider relations team.

          Are live-in caregivers still exempt, and what is changing next for Virginia EVV?

          No. Virginia's EVV exemption for live-in caregivers ended on October 1, 2026. DMAS announced the change in a bulletin issued under the 2026 Appropriation Act, and it covers agency-directed aides and consumer-directed attendants. The exemption had been in place since January 1, 2021, with live-in claims billed using the UB modifier.

          Important: DMAS has not spelled out every detail for agency-directed live-in aides. The bulletin does not say how agencies should handle the UB modifier on live-in claims after October 1, 2026, or whether agency claims for live-in aides without EVV data are now denied. Confirm the billing rules with DMAS or with the health plan you bill before you change how you bill these visits.

          For consumer-directed services the picture is clearer. Since October 1, 2026, all attendants, including live-in attendants and paid legally responsible individuals, must clock in and out with the Fiscal/Employer Agent's mobile app or phone line. The web portal is not an approved EVV method.

          What is changing next: a DMAS one-page guide written for consumer-directed attendants says there will be no compliance penalties for the live-in requirement before January 1, 2027. That suggests enforcement could begin on or after that date, but DMAS has not published the penalty terms. We also did not find a statement that the same grace period applies to agency claims, so agencies should not assume it does.

          One more point to watch: the published text of the state EVV regulation still lists live-in caregivers as exempt. It has not yet been updated to match the bulletin, so the bulletin is the current guide. We did not find any upcoming change that is specific to home health as of our last check.

          Get notified when Virginia EVV rules change

          Leave your email and we will let you know when Virginia changes its EVV requirements. No newsletter, only changes for this state.

          Who to ask about Virginia EVV

          Questions about Virginia EVV rules are best put to the state. Start with DMAS: Electronic Visit Verification.

          Virginia EVV sources

          Related reading

          Page history

          • October 7, 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 Virginia home care agencies. If you would like to talk through Virginia's requirements, contact Ankota or read more about Ankota's EVV software.

          Virginia

          Mr. Cory Gustafson
          Department of Vermont Health Access
          280 State Drive
          Waterbury, VT 05671

          Questions about EVV?

          EVV is still to be implemented in most of the states with different guidelines and regulations. We’re keeping up with the updates related to EVV implementation and if there is something we haven’t included, please share with us. To learn how ankota can help in ensuring compliance, please get in touch with us.

          Virginia EVV questions

          Who is the EVV aggregator in Virginia?

          Virginia does not have a statewide EVV aggregator. The EVV data is submitted on the claim itself and kept in the DMAS Medicaid Enterprise System. Two health plans add their own gateway: Humana Healthy Horizons requires HHAeXchange and Anthem HealthKeepers Plus requires the Netsmart EVV clearinghouse.

          Can I choose my own EVV software in Virginia?

          Yes, for agency-directed services. Virginia is a provider choice state, so each agency selects and pays for its own system. DMAS does not approve or certify EVV vendors, so the agency is responsible for choosing a system that meets the state regulation and the reporting requirements of DMAS and the health plans it bills.

          Does Virginia deny Medicaid claims without EVV?

          Yes. Claims for agency-directed personal care, respite and companion services that are missing the EVV data have been denied for dates of service on or after September 1, 2020. Home health claims with EVV errors have been denied since January 1, 2024. Paper and direct data entry claims are not accepted for these services.

          Which Virginia Medicaid services require Electronic Visit Verification?

          Visit verification is required for agency-directed personal care (T1019), respite (T1005) and companion (S5135) services, and for home health services billed under the EVV revenue codes. Hospice and private duty nursing are excluded. Consumer-directed services also require it, through the Fiscal/Employer Agent's tools.

          Are live-in caregivers exempt from EVV in Virginia?

          Not anymore. The live-in caregiver exemption ended on October 1, 2026 for agency-directed aides and consumer-directed attendants. DMAS guidance written for consumer-directed attendants says there will be no compliance penalties before January 1, 2027. DMAS has not published full billing details for agency-directed live-in aides, so agencies should confirm those with DMAS.

          Does Humana Healthy Horizons require HHAeXchange in Virginia?

          Yes. Humana Healthy Horizons in Virginia requires all EVV claims to go through HHAeXchange, and EVV claims for dates of service on or after October 29, 2025 that are submitted another way are denied. Providers can use the Humana-sponsored HHAeXchange tool at no cost or another EVV vendor that is fully integrated with HHAeXchange.

          Does Anthem HealthKeepers Plus have its own visit verification requirement?

          Yes. Anthem HealthKeepers Plus requires providers to submit EVV data through the Netsmart EVV clearinghouse. An agency that uses a different EVV vendor connects that vendor to Netsmart. This is an Anthem requirement and does not apply to other Virginia health plans.

          How does electronic visit verification work for consumer-directed services in Virginia?

          For consumer-directed services, the Fiscal/Employer Agent selects and runs the EVV system. Attendants clock in and out using the mobile app or phone line from Consumer Direct Care Network or Public Partnerships LLC, and the web portal is not an approved method. Since January 1, 2025, shifts submitted more than 30 calendar days after the service may be denied, with limited exceptions.

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