Electronic Visit Verification

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

21st Century Cures Act Updates

The EVV practice period has been extended to Dec. 31 and the timeline has been updated 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 guides below provide a list of topics and points of contact for EVV-related questions and issues:

EVV Proprietary Systems

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.

EVV Visit Maintenance Unlock Request

Program providers must:

  1. Email the Visit Maintenance Unlock Request (Excel) spreadsheet securely to your payer because it contains protected health information.
  2. Include “Visit Maintenance Unlock Request” in the email subject line.

Requests that are not emailed securely, or with the required email subject line may be delayed or denied by your payer. See the Instructions tab in the Excel spreadsheet for more information.

Policy

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

Rights and Responsibilities

Fee-for-Service

Managed Care

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.

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

Training

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