ABA Buyer Intent Guide
Electronic Visit Verification is shifting from a warning to a wall. In 2026 several states move home-based Medicaid services from soft edits to hard edits that automatically reject claims without a matching visit record. Here is what is confirmed and how to stay ahead of it.
Quick answer
Under the 21st Century Cures Act, states are moving home-based Medicaid services from soft EVV edits to hard edits that auto-reject non-compliant claims. Confirmed 2026 examples include Missouri, Michigan, Minnesota, and Pennsylvania. EVV was never federally mandated for ABA, but several states extended it. This is not legal advice.
A soft edit warns you that a claim is missing an EVV match but still lets it through. A hard edit rejects the claim outright. The 2026 wave is the move from soft to hard: the same missing GPS or attested exception that used to be a warning becomes an automatic denial.
Missouri planned a soft launch on January 7, 2026 and a hard launch on April 1, 2026. Michigan’s MDHHS moved to full enforcement on April 1, 2026, with an 85 percent no-manual-edit quarterly threshold. Minnesota began enforcement in January 2026 with a 50 percent floor rising toward 80 percent. Pennsylvania flags providers over a 15 percent manual-edit threshold.
Dates and thresholds vary by state and payer, so always confirm against your own state guidance.
In the Infinite Suite OS demo, every visit is built to carry the six Cures Act EVV elements, and a recovered session closes with a compliant EVV record or an honest attested exception on the record, never a silent gap. That is a labeled demo capability on fictional data, shown so you can see the pattern that keeps claims off the hard-edit reject pile.
EVV was never federally mandated for ABA under the 21st Century Cures Act, which targeted personal care and home health services. Several states, however, extended EVV to ABA and other home-based Medicaid services, so it depends on your state and payer.
A hard edit automatically rejects a claim that lacks a matching EVV record, instead of just warning about it. The 2026 wave is states moving from soft edits to hard edits for home-based Medicaid services.
Capture the six Cures Act elements at the point of care, keep manual edits below your state’s threshold, and make sure every visit closes with a compliant record or a documented attested exception before the claim goes out.
EVV was never federally mandated for ABA under the 21st Century Cures Act, but several states extended it to ABA and other services. Rules, thresholds, and enforcement dates vary by state and payer. This page is general information, payer-neutral, and is not legal advice.