MedicaidAdministrativeMedium impact
MAB2025082901
Pennsylvania Medicaid (DHS)·PA · Occupational Therapy, Physical Therapy, Speech Therapy·Provider Bulletin
Effective date
Aug 29, 2025
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance will begin issuing quarterly alerts starting January 2026 to providers whose Electronic Visit Verification (EVV) manual edit rates exceed 15% for Personal Care Services and Home Healthcare Services. Providers exceeding thresholds for two consecutive quarters will face formal noncompliance notices and must submit corrective action plans, with potential sanctions for continued noncompliance.
Action Required
By January 2026: Providers rendering Personal Care Services (PCS) and Home Healthcare Services (HHCS) in Pennsylvania must monitor EVV Compliance reports monthly in the EVV Aggregator to ensure manual edit rates stay below 15%. Access reports by logging into Aggregator > Reports > Date Range Reports > EVV Compliance. Develop internal monitoring processes and staff training protocols now to avoid formal noncompliance notices and required corrective action plans starting in 2026.