Massachusetts EVV Compliance

MassHealth Uses Sandata for EVV.
Here's What Your Agency Needs to Know.

Massachusetts MassHealth requires Sandata as its EVV aggregator under a Hybrid model. Every qualifying home care visit must have a clean, resolved Sandata record before billing can proceed. CareBravo manages exception resolution and billing readiness as delivered operational work.

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Massachusetts EVV — Quick Reference

What MassHealth Requires

Requirement
Detail
State Agency
EOHHS — Executive Office of Health and Human Services (MassHealth)
EVV System
Sandata (state-designated aggregator)
EVV Model
Hybrid — Sandata aggregator, agency-choice capture method
Services Covered
Personal Care Services, Home Health aide services, qualifying HCBS waiver services
Key Programs
MassHealth Adult Supports Waiver, ABI Waiver, Moving Forward Plan, PCA Program
Enforcement
Claims require matching, resolved EVV record in Sandata to process
How It Works

Sandata, Hybrid Model, and the Daily Compliance Discipline

Massachusetts's Hybrid model gives agencies flexibility in how they capture EVV data — Sandata's own app, telephony, or compatible third-party tools. The aggregator is Sandata, and that part isn't flexible. All visit records must reach Sandata before a MassHealth claim can be processed.

Massachusetts operates a mature Medicaid managed care environment. Agencies serving members through managed care plans may encounter plan-specific requirements layered on top of the MassHealth Sandata baseline. Verify specific EVV submission requirements with each managed care plan you are contracted with, in addition to EOHHS's baseline requirements.

CareBravo manages the Sandata exception queue as part of its daily delivered operations for Massachusetts agencies — including plan-specific submission requirements where applicable.

The Real Cost

Sandata Exceptions Block MassHealth Billing

Unresolved Sandata exceptions block billing for affected visits. For a 30-patient Massachusetts agency, a week's exception backlog typically represents $900–$1,800 in delayed revenue. CareBravo resolves exceptions daily — Massachusetts agencies receive billing-ready outputs without a separate reconciliation step before billing.

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Questions

Massachusetts EVV — Common Questions

MassHealth uses Sandata as its state-designated EVV aggregator under a Hybrid model. All qualifying home care visits must submit EVV data to Sandata before claims can process. Agencies choose their own capture method — the aggregator destination is Sandata.

Massachusetts's Personal Care Attendant (PCA) Program and related personal care programs are subject to EVV requirements under the federal mandate. EVV data for PCA services must flow through Sandata. Verify specific service code coverage and any PCA-program-specific EVV submission requirements directly with EOHHS, as PCA program administration has specific rules that may differ from standard personal care services.

Yes. Massachusetts's Hybrid model allows any compliant capture tool that submits visit data to Sandata. Confirm your tool has a working Sandata integration before relying on it for MassHealth billing. Also verify any managed care plan-specific requirements beyond the MassHealth baseline.

CareBravo integrates with Sandata and manages exception resolution, visit reconciliation, and MassHealth billing readiness as delivered operational work. Massachusetts agencies receive billing-ready outputs without managing the Sandata exception queue themselves.

Massachusetts EVV Compliance, Delivered

CareBravo manages Sandata exception resolution and MassHealth billing readiness for Massachusetts home care agencies — as completed operational work.

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