Electronic Visit Verification (EVV) in West Virginia
All states: EVV requirements map
In short: HHAeXchange is the free state EVV system and the aggregator, and agencies may use their own system that feeds it. EVV claims must carry the caregiver's NPI. Change ahead: West Virginia has said all EVV claims will eventually have to go through the state system. No date is set.
West Virginia EVV at a glance
| EVV model | Open/Hybrid. Use the free state system or your own EVV software. |
|---|---|
| State EVV system | HHAeXchange (HHAX), free to agency providers. |
| Aggregator | HHAeXchange |
| Can I use my own EVV vendor? | Yes, at your own cost. The vendor must be certified with HHAeXchange and send visits in real time. |
| Are claims denied without EVV? | Partly. Claims deny without the caregiver's NPI (since November 1, 2022). We did not find a rule that denies a claim for a missing visit match. |
| Live-in caregivers | Exempt from EVV in the Aged and Disabled Waiver, TBI Waiver and State Plan Personal Care. |
| Upcoming change | A rule to send all EVV claims through HHAeXchange is postponed, with no date set. |
Last verified against state sources: 2026-10-08.
How does EVV work in West Virginia?
West Virginia uses what the state calls an Open/Hybrid EVV model. The Bureau for Medical Services (BMS) contracts with HHAeXchange (HHAX), which provides a free EVV system for agency providers and also acts as the state's aggregator. An agency can use that free system, or buy its own EVV software that sends visit data to the HHAeXchange aggregator. EVV for personal care services started on March 1, 2021.
For home care agencies, EVV applies to these programs:
- Aged and Disabled Waiver (ADW): personal attendant services.
- Traumatic Brain Injury Waiver (TBIW): personal attendant services.
- State Plan Personal Care: the Personal Care manual says providers must implement EVV as determined by BMS.
- I/DD Waiver (IDDW): home-based agency person-centered support, in-home respite and out-of-home respite.
If you choose your own EVV software, HHAeXchange's West Virginia requirements say the vendor must pass HHAX certification, complete an attestation, and send visit data in real time. The agency pays for that software, and it must be the only EVV system used under that provider number.
Two paths sit outside this agency setup. Self-directed members in the Personal Options program use EVV provided by Palco, the program's financial management services vendor. Home health and private duty nursing were added to HHAeXchange in a separate phase, and we did not confirm the claim rules for those services, so check with BMS if you bill them.
Does West Virginia deny Medicaid claims without a verified EVV visit?
Not in the way some states do. What is confirmed is a caregiver NPI rule: for dates of service on or after November 1, 2022, a claim for an EVV service that is billed outside HHAeXchange denies if it does not carry the enrolled caregiver's individual National Provider Identifier (NPI). We did not find a West Virginia rule that denies a claim because no matching EVV visit is on file.
Important: Not finding a visit-match denial rule is not the same as the state saying there is none. EVV is still required for these services, and BMS can change how it enforces the requirement. Ask BMS how claims without a matching visit are treated before you rely on either answer.
Here is what the state's own documents say about billing:
- Caregiver NPI: every personal attendant needs an individual NPI, and that NPI goes on the claim. This is the rule that causes denials today.
- Billing through HHAeXchange: BMS planned a claims edit that would require all EVV service claims to be submitted through HHAeXchange. That edit was postponed more than once in 2022, and its November 1, 2024 date was withdrawn in a BMS memo dated September 12, 2024.
- Billing the fiscal agent directly: the same memo lets agencies bill Gainwell, the state's fiscal agent, directly when HHAeXchange issues occur.
We did not find any later notice that puts the HHAeXchange billing edit in effect. In practice, the safest habits are the simple ones: make sure every caregiver has an NPI on file before the first visit, and make sure every visit is captured, even where a claim would still pay without it.
What else do West Virginia agencies need to get right?
Most of the day-to-day work comes down to caregiver setup and knowing which visits are exempt. Each personal attendant needs an individual NPI, attendants check in and out of every visit, and live-in caregivers are treated differently. Getting these right at hiring time prevents most billing problems later.
- Live-in caregivers: in the Aged and Disabled Waiver, an attendant who lives in the member's home is exempt from EVV and from the NPI requirement for that member. The state's FAQ applies the same live-in answer to the TBI Waiver and State Plan Personal Care. These visits are billed to Gainwell with the UK modifier, or the agency may use HHAeXchange without it. We did not find the same exemption stated for the I/DD Waiver, so confirm with BMS.
- When an attendant cannot use the app: the Aged and Disabled Waiver manual lets the agency install a FOB device in the member's home.
- Case management: Aged and Disabled Waiver case management claims go to Gainwell, and the state's FAQ says TBI Waiver case managers are not required to use EVV.
- One EVV system per provider number: an agency that uses its own EVV software cannot split visits between that software and the free state system under the same provider number.
- Vendor choice in the I/DD Waiver: the I/DD Waiver manual says providers may use an EVV vendor of their choice that meets the federal Cures Act requirements.
None of this is hard on a single visit. It gets hard across hundreds of visits a week, which is why agencies that review exceptions every day have fewer surprises at billing time.
What is changing next for West Virginia EVV?
No dated change was found as of our last check. The one open item is the postponed claims edit that would require all EVV service claims to go through HHAeXchange. The September 12, 2024 BMS memo says the edit will be implemented after issues with authorizations, the caregiver and office setup, and third-party billing integration are resolved, and it gives no date.
We did not find anything newer on this edit in later state documents, including the 2026 Aged and Disabled Waiver and I/DD Waiver manuals. That means the edit could be announced again, and we cannot say when. If your agency bills Gainwell directly for EVV services, watch for BMS notices and ask BMS about the current status of the edit.
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Who to ask about West Virginia EVV
Questions about West Virginia EVV rules are best put to the state. Start with WV Bureau for Medical Services: Electronic Visit Verification (EVV). The state lists DHHRBMSEVV@wv.gov for EVV questions.
West Virginia EVV sources
- WV Bureau for Medical Services: Electronic Visit Verification (EVV)
- WV DHHR: EVV vendor award notice (HHAeXchange)
- WV BMS memo: EVV billing through HHAeXchange (September 12, 2024)
- WV BMS: EVV frequently asked questions for ADW, TBIW and Personal Care
- WV BMS Provider Manual Chapter 501: Aged and Disabled Waiver (effective June 1, 2026)
- WV BMS Provider Manual Chapter 513: I/DD Waiver (effective August 1, 2026)
- WV BMS Provider Manual Chapter 517: Personal Care Services
- HHAeXchange: EVV Data Aggregation Business Requirements for West Virginia
- HHAeXchange: EVV Data Aggregator API specifications for West Virginia
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
- EVV Software Demo Checklist: What to Ask and Test Before You Buy
- What is EVV Software?
- EVV requirements for every state (map)
Other states that use HHAeXchange
Illinois, Michigan, Minnesota, Mississippi, New Jersey, Texas. 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 West Virginia's requirements, contact Ankota or read more about Ankota's EVV software.
Ms. Cynthia E. Beane
West Virginia Department of Health and Human Resources
Bureau for Medical Services
350 Capitol Street, Room 251
Charleston, WV 25301