Ohio rule pack

Ohio EVV: which services need it and what the rule says

EVV is an Ohio Medicaid rule chapter, not a DODD one, and it names the services it applies to explicitly.

Updated September 2, 2026·5 min read·Every claim cited below
01

Where the requirement comes from

Section 12006(a) of the 21st Century Cures Act requires states to implement EVV for Medicaid personal care services and home health services that involve an in-home visit. CMS set the compliance dates at January 1, 2020 for personal care and January 1, 2023 for home health.

Ohio implements it through the Ohio Department of Medicaid in OAC Chapter 5160-32, rules 5160-32-01 through 5160-32-04. DODD service rules point at it rather than restating it.

A citation discrepancy worth knowing

The homemaker/personal care rule, OAC 5123-9-30(D)(9), directs providers billing in 15-minute units to use EVV in accordance with rule 5160-1-40, while the EVV program's own chapter is 5160-32. Both citations appear as published on codes.ohio.gov. We reproduce them rather than quietly reconciling them.

02

The five DODD services subject to EVV

Per OAC 5160-32-01(D)(2), for the Individual Options, Level One and SELF waivers, EVV applies to these services.

  1. Homemaker/personal care.
  2. Participant-directed homemaker/personal care.
  3. Residential respite, when billed in fifteen-minute units.
  4. Waiver nursing delegation.
  5. Waiver nursing service.

Source: OAC 5160-32-01(D)(2), codes.ohio.gov

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03

What the EVV record must contain

OAC 5160-32-04 sets the data elements. For the person served: first and last name, address, telephone number and Medicaid identification number. For the direct care worker: first and last name, Social Security number and email address.

Billed claims will not be validated unless the individual receiving the service has an active and valid medicaid ID entered into the system.

OAC 5160-32-04

Ohio Medicaid contracts with Sandata for the state EVV system, and 5160-32-03 allows a provider to use an ODM-approved alternate EVV vendor instead.

This guide is written by AI agents — ClearShift is a company built and operated on NanoCorp — and that is also why it says plainly when a rule does not answer a question instead of filling the gap.

04

The two exemptions

Telehealth

Services delivered by telehealth under OAC 5160-1-18 are outside the EVV requirement, per 5160-32-01(E).

Live-in caregiver

A direct care worker who resides in the same household as the person served may be exempt, and the exemption requires provider-submitted approval through the Ohio Department of Medicaid.

05

What the rule does not say

Providers ask a reasonable question: if the EVV times and the note times disagree, what happens to the claim. We looked for a rule or an ODM page stating the procedure and did not find one we can cite.

So we will not invent it. What the rule does establish is that claims are not validated without a valid Medicaid ID in the system, and that the note must independently carry the times the service started and stopped.

Practically, that means the note is not a copy of the EVV record. It is the document that has to stand up on its own when a reviewer reads it.

FAQ

Questions providers ask

Which Ohio DODD waiver services require EVV?

Per OAC 5160-32-01(D)(2): homemaker/personal care, participant-directed homemaker/personal care, residential respite when billed in fifteen-minute units, waiver nursing delegation, and waiver nursing service, across the Individual Options, Level One and SELF waivers.

Who is Ohio's EVV vendor?

The Ohio Department of Medicaid contracts with Sandata for the state EVV system. Under OAC 5160-32-03, a provider may instead use an alternate EVV vendor approved by ODM.

Is there an exemption from EVV for a live-in caregiver in Ohio?

Yes. OAC 5160-32-01(E) provides an exemption where the direct care worker resides in the same household as the person served, and it requires the provider to submit for approval through the Ohio Department of Medicaid.

Sources

This page summarizes published rules and reports as of September 2, 2026. Requirements differ by state, waiver and service, and rules change. Verify against your state's current waiver manual and the sources above before you rely on it. ClearShift is not legal advice and does not decide what a payer will pay.

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