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States · Texas

Texas EVV and Medicaid home care, in plain words.

Texas runs Medicaid home care through HHSC, and most adult clients are in a STAR+PLUS health plan. Every personal care and home health visit must be recorded in the state’s EVV system or an approved one. If a claim does not match a recorded visit, it is denied.

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Texas at a glance

EVV, Medicaid and billing in Texas.

Medicaid agencyTexas Health and Human Services Commission (HHSC). TMHP (Texas Medicaid & Healthcare Partnership, operated by Accenture) runs claims and the EVV systems for HHSC.
EVV modelState-provided EVV system plus approved proprietary systems, all feeding the state EVV Aggregator. HHSC calls outside systems ’proprietary systems’ run by an approved Proprietary System Operator (PSO).
State EVV systemEVV Aggregator managed by TMHP; state-provided EVV system is HHAeXchange (HHSC contract awarded 2023).
Your own EVV vendor allowed?Yes, if the system is approved by HHSC/TMHP as a proprietary EVV system and the agency (or vendor) is an approved Proprietary System Operator.
Services that need EVVMedicaid personal attendant and other personal care services listed by HHSC (fee-for-service and managed care, including STAR+PLUS, Community First Choice, Primary Home Care, Community Attendant Services); Medicaid home health services since Jan 1, 2024.
Where you billTMHP (fee-for-service, TexMed Connect) and each MCO’s claims system for managed care members; EVV claims are checked against the EVV Aggregator.

Dates that matter: Home health: required Jan 1, 2024, and EVV claims without a matching EVV visit are denied. Users of the old vendors had to move to HHAeXchange or get PSO approval by Oct 1, 2023.

Licensing: Home and Community Support Services Agency (HCSSA) license from HHSC, with the Personal Assistance Services category for non-medical personal care.

Managed care: Yes, largely. Most adults receiving long-term services and supports are in STAR+PLUS managed care; some personal care (e.g., PHC, CAS) remains fee-for-service through HHSC. Plan line-up varies by service area; check HHSC’s STAR+PLUS plan list.

Programs that pay for care at home

Same rules, same tangle

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

The caregiver taps in. The visit goes to your state’s EVV system. 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, Texas 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 Texas

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

Do I have to use the state’s EVV system?

No. Texas offers a free state EVV system, but you can use another system if HHSC approves it as a proprietary system. Either way, every visit ends up in the state EVV Aggregator, and that is what your claims are matched against.

What happens if a visit is not in EVV?

The claim is denied. Texas matches each EVV-required claim to a recorded visit in the state EVV Aggregator. For home health this started January 1, 2024, and personal care has been matched for longer. Fix missing or wrong visits in the EVV system before you bill, not after the denial arrives.

What license do I need for non-medical personal care?

A Home and Community Support Services Agency license from HHSC with the Personal Assistance Services category. After that you enroll in Texas Medicaid through TMHP and, for STAR+PLUS clients, contract with each health plan in your area.

Who approves my client’s hours in STAR+PLUS?

The client’s health plan. The plan’s service coordinator builds the service plan, and you need that approval before you deliver and bill. Hours and dates on your claims must match both the approval and the EVV visit.

Sources for this guide

Checked 28 Oct 2026. State rules change. Confirm with the Texas Health and Human Services Commission (HHSC). TMHP (Texas Medicaid & Healthcare Partnership, operated by Accenture) runs claims and the EVV systems for HHSC. before you act.

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

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