EVV Live-In Caregiver Exemption: State-by-State Rules for Homecare Agencies

Does the Federal EVV Rule Cover Live-In Caregivers?

Sagar Kumar, COO and Co-Founder, Verveware

Whether a live-in caregiver has to clock in and out depends on the state. This guide covers every open-model EVV state we could verify, meaning states that let homecare agencies use their own or a third-party EVV system and send visits to the state. For each one, you'll see whether live-ins are exempt, what to keep on file and where to check the official rule.

No. In an August 8, 2019 bulletin, CMS said EVV requirements under the 21st Century Cures Act don't apply when the caregiver and the client live together, because that care isn't an "in-home visit." CMS also said states may still require EVV, particularly when services are billed in hourly or other discrete units.

That leaves each state to decide. Some exempt live-ins once paperwork is on file, some exempt only certain programs or billing codes, and some require EVV for everyone. New to EVV? Start with what an EVV system is.

Live-In Caregiver EVV Rules by State

States That Exempt Live-Ins With Paperwork

In most exempt states, the exemption starts only once a form or approval is on file. Illinois DDD and Ohio require approval before you stop using EVV, and Michigan caregivers use EVV while a request is pending, except in Home Help. Colorado, Illinois DDD and Michigan exemptions expire unless renewed. In Delaware, Maine, North Carolina, West Virginia and Wisconsin, a claim modifier or place-of-service code tells the payer the visit is exempt.

In Illinois, HFS says DDD is the only program that lets live-in caregivers apply for an EVV exemption, so IDoA Community Care Program (CCP) live-ins still use EVV. Since March 2, 2026, CCP in-home visits go to HHAeXchange, either through its state-sponsored portal or a connected third-party EVV system. Wisconsin exempts live-ins for personal care and Supportive Home Care but still requires EVV for home health and the RN supervisory visit (99509).

States With Partial Exemptions

Indiana, New Hampshire, North Dakota and Washington exempt only certain programs, payment types or employers. Minnesota doesn't exempt live-ins, but lets them enter EVV data once a day instead of in real time.

States That Still Require EVV

Arizona, Connecticut, Hawaii, Iowa, Missouri, Montana, Nebraska, Pennsylvania, Texas and Virginia require EVV for live-in caregivers. Virginia ended its exemption on October 1, 2026.

How Verveware Helps Agencies With Live-In Caregivers

Where an exemption exists, it's only as good as your records. Keep the signed attestation or exemption form, proof of shared residence, the approval and renewal dates, and any change in living arrangement. An exemption covers only the client the caregiver lives with, so visits to any other client still need EVV.

Verveware works with any state's EVV setup. For caregivers who still use EVV, Verveware EVV captures all six required data points at the moment of care. The Aggregator Dashboard shows each submission's status and the aggregator's reason for any rejection.

As a third-party EVV vendor, Verveware sends Illinois visits to HHAeXchange and connects to Michigan's EVV aggregator (HHAeXchange). It's certified as an alternate EVV system in Wisconsin and listed by AHCCCS as an alternate EVV vendor in Arizona. Store attestation forms and proof of residence in Verveware, then use Document Manager to find or bulk export them when a program asks.

Verveware supports your records; it doesn't replace documentation required by your state Medicaid agency. Confirm current rules with your state before changing how live-in visits are recorded or billed.

FAQ

Are Live-In Caregivers Exempt From EVV?

Under CMS guidance, EVV isn't federally required when the caregiver and client live together, but each state decides. California, Colorado, Delaware, Illinois DDD, Maine, Michigan, New Jersey, New York, North Carolina's CAP waivers, Ohio, Utah, Vermont, West Virginia and Wisconsin exempt live-ins in certain cases. Arizona, Connecticut, Hawaii, Iowa, Missouri, Montana, Nebraska, Pennsylvania, Texas and Virginia require EVV, as does Illinois's IDoA Community Care Program.

Who Counts as a Live-In Caregiver for EVV?

Generally, a caregiver whose permanent home is the client's home. Each state sets its own definition and proof. New York requires a shared permanent residence, while California counts a caregiver who regularly stays more than 24 hours at a time.

Does the Live-In Exemption Apply to All of a Caregiver's Clients?

No. A live-in exemption applies only to the client the caregiver lives with. Visits to any other client still need EVV.

Can an Agency Require EVV for Live-In Caregivers Anyway?

Yes, in several states. New York lets MCOs, providers and fiscal intermediaries collect EVV data for exempt live-ins based on business needs, and Wisconsin lets HMOs, MCOs and agencies require it. West Virginia agencies can choose to have live-ins clock in and out.

Which States Ended or Narrowed Their Live-In Exemption?

Virginia ended its live-in exemption on October 1, 2026. North Dakota limits its exemption to daily-rate live-in personal care, so unit-rate live-ins still use EVV.

See Live-In Caregiver EVV in Verveware

Request a Verveware demo to see EVV, document storage and the Aggregator Dashboard working together for your agency. Book a demo.