Georgia EVV Requirements: What Home Health & PCS Agencies Need to Know (2026)

Georgia home health agencies and personal care service providers are required to use Electronic Visit Verification (EVV) for all Medicaid-reimbursed personal care services and home health services that include skilled nursing or therapy visits at home. Georgia uses Sandata as its state-designated EVV aggregator, and compliance is enforced through the Georgia Department of Community Health (DCH) and managed care organizations.

What Is EVV and Who Must Comply?

EVV is a technology system that captures visit data at the point of care in real time. Under the 21st Century Cures Act (Public Law 114-255), all states must require EVV for Medicaid-funded personal care services and home health services by federal mandate. Georgia implemented EVV requirements in phases, with full enforcement for PCS providers effective 2023.

Who must use EVV in Georgia:

• Medicaid home health agencies (skilled nursing, PT, OT, SLP)
• Personal care services providers
• Agencies serving participants in CCSP, SOURCE, and other HCBS waivers
• Self-directed care programs where a family caregiver is the paid provider of record

What Are the Six Required EVV Data Points?

CMS requires EVV systems to capture all six of the following data points for every covered visit:

1. Type of service performed
2. Individual receiving the service (patient identity)
3. Date of the service
4. Location of service delivery
5. Individual providing the service (caregiver identity)
6. Time the service begins and ends

A visit record missing any of these six elements is considered an EVV exception. Exceptions do not automatically result in recoupment, but they create audit exposure and must be resolved or documented within the timeframes established by the Georgia DCH and applicable managed care organizations.

What Is Georgia's EVV System, and Why Sandata?

Georgia designated Sandata as its state EVV aggregator. Sandata serves as the centralized data repository that receives visit data from provider EVV systems or directly from caregivers using the Sandata Mobile Connect app. Providers who use a different EVV vendor (an "alternate EVV system") must ensure their system integrates with and transmits data to Sandata in real time.

The Sandata system captures:

• GPS coordinates at clock-in and clock-out
• Caregiver identity (via mobile login or telephony verification)
• Visit timestamps
• Patient and service type data populated from the provider's system

What Are EVV Exceptions, and What Are the Consequences?

An EVV exception occurs when a visit record is missing required data, contains conflicting data, or cannot be matched to a corresponding claim. Georgia DCH and MCOs monitor exception rates and use them as a compliance indicator.

Common exception types in Sandata:

• Location exception — GPS coordinates at clock-in or clock-out do not match the patient's verified address of record
• Duration exception — visit duration is outside the authorized service window, too short or too long
• Missing field exception — one or more of the six required data points is absent
• Unmatched claim — a claim was submitted for a visit with no corresponding EVV record in Sandata
• Duplicate record — multiple visit records exist for the same caregiver, patient, and overlapping time window

Consequences of unresolved exceptions:

• Claim denial or recoupment by the MCO
• Inclusion as a finding in a state or federal audit
• Flag for pre-payment review or post-payment audit
• In cases of pattern non-compliance, referral to the Georgia Medicaid Fraud Control Unit (MFCU)

How Does Georgia Enforce EVV Compliance?

Georgia enforces EVV compliance through a layered system:

• Georgia DCH monitors statewide EVV data through Sandata's reporting infrastructure and reviews exception rates by provider — providers with persistently high exception rates may be subject to focused audits.
• Managed Care Organizations (MCOs) — Amerigroup, Peach State Health Management, WellCare, and CareSource — conduct their own EVV audits for their enrolled populations and may conduct post-payment reviews that result in recoupment.
• CMS monitors state EVV programs through annual compliance reviews and can withhold federal matching funds from states that do not demonstrate adequate enforcement.

What Should Agencies Do Now?

1. Run a baseline EVV exception analysis across at least 90 days of Sandata data.
2. Identify your top exception categories and root causes.
3. Implement pre-claim exception review — catch exceptions before claims are submitted.
4. Ensure all caregivers are properly credentialed in your system and LEIE-screened.
5. Document your exception resolution process in writing — this is your audit defense.