HHSC is issuing temporary EVV policies in response to the coronavirus (COVID-19).
What is Electronic Visit Verification?
Electronic Visit Verification is a computer-based system that verifies the occurrence of authorized personal attendant service visits by electronically documenting the precise time a service delivery visit begins and ends. Texas requires EVV for certain Medicaid funded home and community-based services provided through the Health and Human Service Commission and managed care organizations.
Programs and Services Required to Use EVV
- See the current Programs and Services Required to Use EVV on page 3.
21st Century Cures Act Updates
The Cures Act EVV Expansion timeline has been posted on the HHSC EVV Cures Act webpage.
By Jan. 1, 2021, the Cures Act EVV Expansion will implement the Cures Act federal EVV requirement for Medicaid personal care services that are not currently required to use EVV by state law.
Compliance
Compliance Oversight Reviews monitor program providers contracted with HHSC and managed care organizations on the use of an EVV system to electronically document authorized service delivery visits. Program providers will be reviewed on a regular basis to ensure they are following EVV policy.
Historical Compliance Plans
Contact Information
The EVV Contact Information Guide (PDF) provides a detailed listing of topics and points of contact for EVV-related questions and issues.
Forms
EVV Rights and Responsibilities
- Fee-for-Service EVV Rights and Responsibilities - English (PDF)
- Fee-for-Service EVV Rights and Responsibilities - Spanish (PDF)
- Form 1718 – MCO EVV Rights and Responsibilities (English and Spanish)
Visit Maintenance
Policy
HHSC EVV Policies
All files are in PDF format unless noted below:
- Allowable Phone Identification Policy
- Billing Policy
- Claims Matching Policy
- Claims Submission Policy
- Compliance Oversight Reviews Policy
- Data Elements Policy
- EVV Proprietary Systems Policy
- EVV Usage Policy
- EVV Vendor Selection Policy (existing program providers)
- EVV Vendor Transfer Policy
- Mobile Application Policy
- Reason Code and Required Free Text Policy
- Reports Policy
- Schedules Policy
- Training Policy
- Visit Maintenance: Last Visit Maintenance Date Policy
- Visit Maintenance Unlock Request Policy
Cures Act EVV Expansion: HHSC EVV Policies
The policies below only apply to program providers and FMSAs delivering services subject to federal Cures Act EVV requirements.
Policy Handbook
Proprietary Systems for EVV
Program providers and FMSAs may choose to seek HHSC approval to use an EVV proprietary system instead of an EVV vendor system to comply with EVV requirements.
More information is on the HHSC EVV Proprietary Systems webpage.
Reason Codes
Program providers must select the most appropriate EVV reason code numbers, reason code description option, and enter any required free text when performing visit maintenance in the EVV system.
Current HHSC EVV Reason Codes
Historical HHSC EVV Reason Codes
Service Bill Codes Table
The EVV Services table below provides current billing codes for EVV-relevant services in Long-Term Care, Acute Care, and Managed Care programs, including billing codes with changes effective Sept. 1, 2019 for STAR+PLUS services.
Program providers must use the appropriate Healthcare Common Procedure Coding System (HCPCS) and modifier combinations in the EVV Services table to prevent EVV visit transaction rejections and EVV claim match denials.
Statutes and Rules
State
- Texas Administrative Code, Title 1, Part 15, Chapter 354
- Texas Administrative Code, Title 40, Part 1, Chapter 41
- Texas Administrative Code, Title 40, Part 1, Chapter 49
- Texas Administrative Code, Title 40, Part 1, Chapter 68
- Texas Government Code, Section 531.024172
Federal
Training
Frequently accessed training resources are listed below. More training information and resources are available on the HHSC EVV Training webpage.