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States · South Dakota

South Dakota EVV and Medicaid home care, in plain words.

In South Dakota, Medicaid is run by the Department of Social Services, but most in-home care for older adults goes through the Department of Human Services and its HOPE Waiver.

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South Dakota at a glance

EVV, Medicaid and billing in South Dakota.

Medicaid agencySouth Dakota Department of Social Services (DSS), Division of Medical Services, runs South Dakota Medicaid. In-home HCBS for older adults and adults with disabilities is operated by the South Dakota Department of Human Services (DHS), Division of Long Term Services and Supports (LTSS); developmental disability waivers by DHS Division of Developmental Disabilities.
EVV modelState-sponsored EVV system (state-contracted vendor).
State EVV systemTherap (per South Dakota Association of Healthcare Organizations reporting of the LTSS EVV rollout, 2019; the state’s current EVV page was not located)
Your own EVV vendor allowed?Unconfirmed. Check with DHS LTSS / DSS before telling agencies they can use another vendor.
Services that need EVVPersonal care under the state plan and 1915(c) waivers (CMS found SD compliant, Dec 2020). Home health and private duty nursing require EVV since January 1, 2024 (DSS letter, April 2025).
Where you billSouth Dakota Medicaid (DSS) MMIS and online provider portal; exact portal name to confirm.

Dates that matter: Personal care: CMS compliance letter dated Dec 31, 2020. Home health: CMS good-faith exemption for 2023; EVV in effect for home health and private duty nursing Jan 1, 2024.

Licensing: Home health agencies are licensed by the SD Department of Health; whether a non-medical in-home care agency needs a state license, or only Medicaid/waiver provider enrollment with DHS, needs checking.

Managed care: Fee-for-service. South Dakota does not deliver HCBS through managed care organizations.

Programs that pay for care at home

Same rules, same tangle

In South Dakota, the visit still gets typed four more times.

The caregiver taps in. The visit goes to Therap. Then someone in your office carries it by hand into payroll, into billing, into the chart, and to the family on the phone. Every carry is a chance for the numbers to drift. When they do, South Dakota denies the claim, and you find out weeks later. That is Tangleware™: good tools, and an owner in the middle.

How one tap at the door runs the whole agencyThe mechanism, the nine agents, and Cary®

CareBravo® in South Dakota

Running an agency in South Dakota? Tell us.

CareBravo works with the EVV systems states use, including Sandata, HHAeXchange and Netsmart. Each state approves its own connection, and each program has its own rules, so we confirm what is in place for South Dakota and your programs before you switch anything. If we are not running in South Dakota yet, we will make you an offer to start now while we build it.

Run the Calculator, or ask for the demo and tell us your state.

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Five promises, written like promises.

  1. Nothing stops. Your current system keeps running while CareBravo runs beside it for two weeks on your real data. The Parallel Promise™
  2. 99%, in writing. On Managed Billing, at least 99% of your claims go out without a mistake we caused. If we make one, we fix it free. We cannot promise what a payer decides. Read the guarantee
  3. The floor, stated up front: $250 a month, no seats, no per-user fees, no implementation fee — and corrections never billed twice.
  4. Thirty days’ notice, either way.
  5. Nobody calls unless you ask.

What South Dakota owners ask.

Do I bill a health plan or the state for HOPE Waiver clients?

You bill South Dakota Medicaid directly. The state does not use managed care plans for in-home care, so there is no plan contract to sign. You do need to enroll your agency with South Dakota Medicaid and be approved by the Department of Human Services to serve waiver clients.

Does home health need EVV in South Dakota now?

Yes. EVV has applied to home health and private duty nursing visits since January 1, 2024. Each visit must show the service, the client, the date, the place, the start and end times, and who gave the care.

Can a family member be the paid caregiver?

For home health and private duty nursing, South Dakota Medicaid says no. Close relatives and people who live in the home cannot be the paid worker. A 2025 state letter gave agencies 30 days to change staffing where that was happening. Check the rules for waiver services separately.

Which EVV system do I use?

The state set up an EVV system for in-home services through its long-term services division. Ask DHS which system to use and whether your own system can send visits to it before you choose anything.

Sources for this guide

Checked 28 Oct 2026. State rules change. Confirm with the South Dakota Department of Social Services (DSS), Division of Medical Services, runs South Dakota Medicaid. In-home HCBS for older adults and adults with disabilities is operated by the South Dakota Department of Human Services (DHS), Division of Long Term Services and Supports (LTSS); developmental disability waivers by DHS Division of Developmental Disabilities. before you act.

You take the bravo. We take the work.

Find out what the tangle costs your agency.

Four minutes. Works for any South Dakota agency today.

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We email you the highlights the moment you ask. No call. Nobody calls unless you ask.

See What’s Draining Your Agency →View the demo