EVV requirements for NEMT: what the Cures Act covers and what it does not

The short answer: federal EVV is not an NEMT rule

Electronic visit verification is a federal Medicaid requirement for in-home care, not for rides. Section 12006 of the 21st Century Cures Act added section 1903(l) to the Social Security Act. That section tells states to require an EVV system for personal care services and home health care services that require an in-home visit by a provider.

Non-emergency medical transportation comes from a different part of Medicaid law. States must assure transportation to medical care under 42 CFR 431.53, and CMS consolidated that guidance in its 2023 Medicaid Transportation Coverage Guide. Nothing in the federal EVV statute pulls NEMT in.

A state can go further than federal law, and Minnesota has. Its 2026 law brings NEMT providers under the state EVV statute starting in 2027, as covered below.

That does not mean you can skip trip records. States and brokers set their own proof-of-service rules, and a few of them look a lot like EVV. The rest of this guide separates the federal rule from the state and contract rules, so you know which ones apply to your company.

What the Cures Act EVV mandate requires

The mandate covers two service types, and both involve a caregiver coming into the home.

The EVV system must electronically verify six things about each visit:

1. The type of service performed
2. The individual receiving the service
3. The date of the service
4. The location of service delivery
5. The individual providing the service
6. The time the service begins and ends

CMS’s EVV FAQ adds two details that matter for anyone who hears “EVV” and thinks “GPS”. There is no federal requirement to use GPS, although it is one way to meet the rule. Capturing the location where the service starts and stops is enough, and states may ask for more to control fraud.

Why NEMT falls outside EVV

EVV applies to services that “require an in-home visit”. A ride to dialysis is not a visit to someone’s home to deliver care. CMS’s FAQ also says personal care that does not require an in-home visit is not subject to the EVV requirement.

Texas says it plainly. The HHSC Electronic Visit Verification Policy Handbook defines non-EVV services as authorized services not required to use EVV, “such as transportation and supported employment”. That handbook governs EVV across Texas Medicaid programs, and transportation sits outside it.

The federal rules that do reach NEMT drivers are about who drives, not how a visit is logged. Section 209 of the Consolidated Appropriations Act, 2021 requires states to make sure every NEMT provider and driver is not excluded from federal health programs, that each driver holds a valid license, and that providers have processes for drug law violations and driving history. Our guide to NEMT driver requirements covers those in detail.

Where the confusion comes from

Three things make operators think EVV applies to them.

• Waiver programs mix services. Texas HHSC’s October 2025 EVV FAQ says some programs allow transportation as part of an EVV-required service, while others offer it on its own. When transportation is a standalone service, EVV is not required. That is a personal care agency question, not an NEMT one.
• Broker GPS rules look like EVV. When a broker asks for start and end coordinates, timestamps, and a signature, it feels like EVV. It is a contract requirement.
• Vendors reuse the term. Some software vendors and blogs call any GPS trip record “EVV”. Treat that as marketing language, and read your actual contract.

Minnesota: EVV for NEMT starting in 2027

Minnesota is writing EVV into its NEMT rules. Laws 2026, chapter 121 (S.F. 4476), signed May 27, 2026, has an article on electronic visit verification. Its first section amends Minnesota Statutes section 256B.0625, subdivision 17. Effective January 1, 2027, or upon federal approval, whichever is later, all NEMT providers must comply with section 256B.073, the state EVV statute.

What section 256B.073, as amended, asks of a provider:

• Use the state-provided EVV system, which is free, or an approved third-party system that sends data to the state in the required format.
• Record the required visit data, including start and end times, at the time of service with an approved verification method.
• Expect claims to be checked against EVV data. The statute says a manual entry does not comply until it is confirmed through the state’s process.

The same chapter lets EVV records that include every required element count toward Minnesota’s NEMT trip documentation rules in subdivision 17b. The Department of Human Services sets the technical details and schedules, so Minnesota operators should watch for its implementation notices. Our Minnesota NEMT guide covers the rest of the state’s rules.

States that require GPS or electronic trip data for NEMT

A handful of states have gone past paper trip logs, and New York is the clearest example.

New York. Effective April 3, 2023, the New York State Department of Health requires all transportation providers to be fully GPS compliant. For a trip to count as compliant, the provider sends the broker the starting point, the end point, and all GPS coordinates along the trip, which the manual calls “breadcrumb data”. Exemptions come only from NYSDOH. The manual says the data supports program integrity, rider safety, and fraud reduction. See our New York NEMT guide for the rest of the state’s rules.

Louisiana. GAO’s 2022 review of NEMT fraud controls reported that officials in Louisiana and New York had mandated GPS tracking for all trips.

Other states. GAO found that in six of the eight states it studied, the state or its contractors used GPS tracking apps to compare trip logs with time-stamped GPS data. Two contractors told GAO that GPS data is more reliable than self-reported trip logs.

Not every GPS rule is about verification. Virginia’s DMAS vehicle standards require a functioning GPS device or a current map in every vehicle, which is about finding the rider, not proving the trip.

What proof of service to keep either way

Whatever your state requires, an auditor will ask you to prove each billed leg happened as billed. GAO’s 2022 summary of HHS-OIG and state NEMT audits found trip records with no date of service or pickup and drop-off locations, and missing proof of driver licenses and vehicle inspections. Seven OIG audits found between 15 and 86 percent of claims out of compliance, depending on the state.

GPS data alone does not close the file. It shows where a vehicle went, but not which rider was on board or whether the trip was authorized. Keep the authorization or trip number and the signature with it. Signature rules vary by payer. In GAO’s review, one broker checked every trip log for a patient signature before paying the provider.

Our NEMT trip log template lays these fields out on one page, and the guide to NEMT documentation requirements covers retention periods.

How to confirm your own requirements

Run this check once a year and whenever you sign a new contract.

1. Open your state Medicaid transportation manual and search for “GPS”, “signature”, and “trip log”.
2. Read the documentation and technology sections of each broker or health plan agreement you hold.
3. Ask each broker’s provider relations contact which trip data they expect and in what format.
4. If you also run a personal care or home health line of business, handle EVV for that line on its own.
5. Write the answers into your driver training so every driver captures the same records.

Recording trips in HealthRide

The HealthRide driver app keeps GPS-recorded miles, pickup and drop-off times, and on-screen signatures on every leg. The trip log report exports those records as a spreadsheet or a PDF when a broker or auditor asks for them. See the driver app and reports pages for how it works.