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Medical Assistance Bulletin 05-24-01 et al. — Updated Electronic Visit Verification Manual Edits Compliance Percentage Requirements

Pennsylvaniasub_regulatoryPA Department of Human Services (OMAP, OLTL, ODP)· effective 2025-01-01

What this rule requires your agency to do

  • 1Each verified EVV visit must contain all six Cures Act service elements (type of service, individual receiving service, date, location, individual providing service, and start/end time); missing elements render the visit incomplete.(Medical Assistance Bulletin 05-24-01 et al. — Updated Electronic Visit Verification Manual Edits Compliance Percentage Requirements)
  • 2Providers must revalidate the MA enrollment of each service location every 5 years and should submit revalidation applications at least 60 days prior to the revalidation date.(Medical Assistance Bulletin 05-24-01 et al. — Updated Electronic Visit Verification Manual Edits Compliance Percentage Requirements)
  • 3Effective with dates of service on and after January 1, 2025, providers must achieve at least 85% of EVV records for verified visits WITHOUT manual edits for both PCS and HHCS, measured on a federal fiscal year quarterly basis.(Medical Assistance Bulletin 05-24-01 et al. — Updated Electronic Visit Verification Manual Edits Compliance Percentage Requirements)
  • 4Providers rendering services across multiple programs (ODP, OLTL, OMAP) must achieve the 85% no-manual-edit threshold separately in each program to be considered fully compliant.(Medical Assistance Bulletin 05-24-01 et al. — Updated Electronic Visit Verification Manual Edits Compliance Percentage Requirements)
  • 5Participants/Common Law Employers in Participant-Directed Services must also meet the 85% threshold or face disenrollment from Participant-Directed Services for continued non-compliance.(Medical Assistance Bulletin 05-24-01 et al. — Updated Electronic Visit Verification Manual Edits Compliance Percentage Requirements)

Applies to: cross-cutting

MA Bulletin raising the EVV manual-edit compliance threshold so that, for dates of service on/after January 1, 2025, providers must achieve at least 85% of EVV records without manual edits for PCS and HHCS.

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