Staying Above 85%: What Pennsylvania Home Care Agencies Need to Know About EVV Compliance

Pennsylvania’s EVV (Electronic Visit Verification) compliance standards have reached a new level. With the 85% auto-verification requirement now in effect for Medicaid-funded services, home care agencies across the state are under pressure to improve the accuracy and timeliness of their visit data.

But here’s the challenge: meeting the Pennsylvania EVV requirements isn’t just about collecting visit data—it’s about ensuring that data is automatically verified through compliant methods, without manual edits.

If your agency is already using an EVV system for home care in Pennsylvania, that’s a great start. But staying compliant—and efficient—requires more than just a basic setup.

Under PA EVV rules, not all visit verifications are created equal. To count toward your compliance rate, a visit must be auto-verified through an approved method—typically a GPS-enabled EVV app or a landline. Telephony via a cell phone or manual entries don’t meet the standard under Pennsylvania Medicaid EVV guidelines. If your caregivers are clocking in manually or editing time entries after the fact, those visits may not help your agency stay above 85%.

Every time your staff manually adjusts a clock-in or clock-out, it’s considered a non-compliant visit under EVV Pennsylvania guidelines. Even if it’s just fixing a minor error, repeated edits can lower your agency’s overall compliance score—and worse, it could lead to audits, delayed reimbursements, or corrective action plans from oversight agencies.

If your current EVV software in Pennsylvania only shows you problems after they’ve already happened, you’re playing catch-up. A stronger approach is real-time validation—automated alerts that let you and your staff know when something looks off before it turns into a compliance issue or a denied claim. This type of proactive support helps agencies hit their compliance benchmarks while saving time and resources.

Each Managed Care Organization (MCO) may have slightly different documentation and validation requirements under Pennsylvania EVV rules. Your EVV system should be able to adjust to these nuances automatically—not leave you manually mapping duties or chasing down mismatched data when it’s time to bill.

Flexibility isn’t a luxury—it’s a necessity in the current EVV PA landscape.

Working Smarter with the Right Software

To consistently meet or exceed the 85% compliance threshold, it’s not just about what EVV app you’re using—it’s about how that app fits into a broader, smarter system.

A strong electronic visit verification Pennsylvania platform should:

• Boost Compliance: Keep your agency compliant by adapting to Pennsylvania Medicaid EVV rule changes automatically.
• Automate Workflows: Simplify time tracking, visit validation, and billing in one place—so your team isn’t juggling multiple tools.
• Prevent Errors: Flag issues before submission, helping you reduce rejections and get paid faster.

Final Thought:

If you’re relying solely on an aggregator or basic tool, you may be missing the deeper functionality needed to stay confidently above 85%. The most successful agencies in Pennsylvania’s EVV system are using real-time automation, compliance checks, and smarter workflows to make EVV one less thing to worry about.

Because at the end of the day, less time fixing errors means more time focused on care.