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Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25)

Delawaresub_regulatoryDelaware Department of Health and Social Services, Division of Medicaid & Medical Assistance (DMMA)· effective 2022-12-30

What this rule requires your agency to do

  • 1All providers must register each MCDID under which they bill for EVV-subject services in the HHAeXchange Provider Registration Portal, indicating whether they will use HHAeXchange or an alternate EVV system (Q46, Q47).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))
  • 2Certain visits are excluded from EVV: services performed entirely outside the home, visits by Medicaid-paid caregivers who reside with the individual, Medicare crossover claims, ABA, social work/dietetic, PDN in schools, and Early Intervention Part C (Q4, Q6, Q7, Q8, Q18, Q24, Q28).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))
  • 3For providers using HHAeXchange, a prior authorization must be present for a worker to sign in and record a visit; the geofencing parameter is 1/4 mile (Q20, Q21).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))
  • 4Web-based timesheets alone are not a permissible form of EVV because they cannot provide auditable confirmation of the six data elements required by section 1903(l)(5)(A) of the Social Security Act (Q14, Q15).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))
  • 5Providers using an alternate EVV system must meet DMMA-prescribed requirements/specifications for alternate systems and send visit data to the HHAeXchange data aggregator (Q2, Q34, Q35).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))
  • 6Beginning November 1, 2025, the State and all MCOs institute a hard claims edit: a claim for an EVV-subject service is checked for a corresponding visit before payment and is denied if no visit is present (Q13).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))
  • 7Visit data must be submitted to the aggregator prior to submitting a claim for payment; alternate-vendor visits should be uploaded within seven days of the date of service (Q34, Q43).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))
  • 8Providers who provide services subject to EVV are required to have an EVV solution in place — either the State's HHAeXchange solution or their own solution meeting State and federal requirements (Q3); go-live for both personal care and home health was December 30, 2022 (Q9).(Delaware DMMA Electronic Visit Verification (EVV) Provider Frequently Asked Questions (12.31.25))

Applies to: personal care

DMMA's EVV provider policy FAQ implementing the 21st Century Cures Act, requiring providers of Medicaid personal care and home health services to capture visits electronically through HHAeXchange (open model) or a compliant alternate EVV system, register in the provider portal, and submit visit data before claims — with a hard claims edit beginning November 1, 2025 denying EVV-subject claims lacking a matching visit.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.