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States · Tennessee

Tennessee EVV and Medicaid home care, in plain words.

In Tennessee, in-home Medicaid care is run through three health plans, called MCOs, under the CHOICES and ECF CHOICES programs. There is no single state EVV system.

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Tennessee at a glance

EVV, Medicaid and billing in Tennessee.

Medicaid agencyDivision of TennCare (Tennessee’s Medicaid agency, within the Department of Finance and Administration). HCBS is delivered by TennCare’s managed care organizations; Area Agencies on Aging and Disability (AAADs) are an entry point for people not yet on TennCare.
EVV modelNo single state aggregator. Each TennCare MCO runs its own EVV system, and agencies must use the system of each member’s MCO.
State EVV systemPer MCO, as named by TennCare: BlueCare uses Sandata; Wellpoint and UnitedHealthcare Community Plan use CareBridge (TennCare memo to MCOs and home health agencies, 2023).
Your own EVV vendor allowed?Yes, with conditions. TennCare says agencies may use a third-party EVV vendor, but must successfully connect to the EVV system or data aggregator of each member’s MCO to be paid.
Services that need EVVCHOICES and Employment and Community First (ECF) CHOICES in-home services such as personal care, attendant care, homemaker, companion and in-home respite (TennCare 2019 memo); home health, private duty nursing and hourly aide services since 2023.
Where you billEach MCO’s claims system; EVV claims flow from the MCO’s EVV system. No single state billing portal for CHOICES services.

Dates that matter: HCBS personal care: compliance required Jan 1, 2020. Home health Phase 1 (PDN, hourly nursing, hourly aide) went live Jan 2023, claim denials by Nov 2023. Phase 2 (intermittent home health) denials began Apr 1, 2024.

Licensing: Non-medical in-home agencies are generally licensed as a Personal Support Services Agency by the Tennessee Department of Health, Board for Licensing Health Care Facilities (confirm current rule).

Managed care: Yes. HCBS is delivered through TennCare managed care (MLTSS). Three statewide MCOs: BlueCare Tennessee, UnitedHealthcare Community Plan, and Wellpoint (formerly Amerigroup).

Programs that pay for care at home

Same rules, same tangle

In Tennessee, the visit still gets typed four more times.

The caregiver taps in. The visit goes to Per MCO. 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, Tennessee 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 Tennessee

Running an agency in Tennessee? 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 Tennessee and your programs before you switch anything. If we are not running in Tennessee 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 Tennessee owners ask.

Why do I need more than one EVV system in Tennessee?

TennCare lets each health plan choose its EVV system. BlueCare uses one system and Wellpoint and UnitedHealthcare use another. If your clients are spread across plans, your visits must reach each plan’s system. You can use your own EVV tool if it connects to each plan’s system.

Do I bill TennCare or the health plan?

You bill the client’s health plan. CHOICES services are paid by the three TennCare MCOs, and each one has its own contract, credentialing, approvals and claims rules. Getting into one plan’s network does not get you into the others.

Can a caregiver sign a paper timesheet if the phone app fails?

TennCare has said manual visit confirmation is not compliant. Plans may allow narrow exceptions for problems outside your control, but they review and track each one. Repeated problems can lead to corrective action plans or a pause on new referrals.

Where do new clients come from?

People already on TennCare ask their health plan about CHOICES. People not yet on TennCare usually start with their local Area Agency on Aging and Disability. Your referrals mostly come from plan care coordinators, so those relationships matter.

Sources for this guide

Checked 28 Oct 2026. State rules change. Confirm with the Division of TennCare (Tennessee’s Medicaid agency, within the Department of Finance and Administration). HCBS is delivered by TennCare’s managed care organizations; Area Agencies on Aging and Disability (AAADs) are an entry point for people not yet on TennCare. before you act.

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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