MedicaidAdministrativeHigh impact
MAB2020061001
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Family Medicine·Provider Bulletin
Effective date
Sep 1, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania is implementing Electronic Visit Verification (EVV) for Medicaid personal care services for beneficiaries under 21, requiring providers to electronically verify six specific data elements including service dates, times, locations, and personnel. Fee-for-Service providers must implement by September 1, 2020, while Managed Care providers have until November 1, 2020, with claims denied if not EVV-verified after grace periods end.
Action Required
By September 1, 2020: Fee-for-Service providers must choose either the state's Sandata EVV system (free) or their own alternate EVV system, complete required training, and begin electronically verifying all personal care services with six required data elements (service type, beneficiary name, date, location, provider, start/end times). By November 1, 2020: Managed Care providers must implement alternate EVV systems. All providers must ensure EVV verification before November 20, 2020 (FFS) or January 1, 2021 (Managed Care) as claims will be denied without proper EVV verification after these dates.