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New York · NYS DOH / eMedNY (Choice Model)

New York EVV: the $14.5 billion matching gap

Electronic Visit Verification decides whether New York Medicaid pays a home-care claim. Here is what the state requires, with dates and sources you can check.

What New York requires

Jan 2021 / Jan 2023

EVV became required for personal-care services (January 2021) and home health care services (January 2023).

Source: NYS DOH EVV program

Choice Model

New York lets providers select and fund their own EVV system; records flow to the state Data Aggregator maintained by GDIT inside eMedNY.

Source: NYS DOH / eMedNY EVV technical guidance

Comptroller audit

The State Comptroller found Medicaid paid $14.5 billion for 82 million personal-care services and $97.6 million for 400,000+ home-health services with no matching EVV record — match rates of just 56% (PC) and 11% (HHC).

Source: Office of the NYS Comptroller audit

Since Jan 1, 2025

Agencies have been expected to reach 90% EVV compliance, per NYSDOH expectations reported in provider guidance.

Source: NYSDOH compliance expectations (reported)

Edit-rate / usage rule

New York publishes no numeric edit ceiling; the requirement is that EVV-applicable claims have a matching record in the aggregator — and the Comptroller has now measured exactly how far the market is from that.

What the Choice Model really means for you

Flexibility cuts both ways: you pick and pay for your own EVV system, and you own the responsibility for getting records into the state aggregator in a format eMedNY can match. There is no free state-provided collection tool to fall back on. When a claim doesn't match, the diagnosis starts at your own vendor's export feed.

The Comptroller's 56%/11% match finding is best read as a warning label: New York has quantified the gap publicly, which is historically what happens shortly before a state starts denying. Agencies that close their own gap before enforcement arrives skip the cliff entirely.

Getting ahead of the match rate

Run the same match the state runs: every billed visit should have an aggregator record agreeing on client, caregiver, service, date, and time. Sampling a week of claims against aggregator records — the exercise our free X-Ray automates for the 835 side — tells you your true match rate before eMedNY tells you theirs.

What are New York EVV denials costing you?

The free X-Ray reads your Medicaid 835 in your browser and shows the EVV denials. The file never leaves your computer.

Run the free Denial X-Ray

Denial codes that hit New York agencies