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 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:
- Email the Visit Maintenance Unlock Request (Excel) spreadsheet securely to your payer because it contains protected health information.
- 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
HHSC EVV Policies
All files are in PDF format unless noted below:
- Claims Matching Policy (PDF)
- Claims Submission Policy (PDF)
- Compliance Oversight Reviews Policy (PDF)
- Data Collection Policy (PDF)
- Electronic Verification Methods Policy (PDF)
- EVV Proprietary Systems Policy (PDF)
- EVV System Selection Policy (PDF)
- EVV System Transfer Policy (PDF)
- EVV Usage Policy (PDF)
- Reason Codes Policy (PDF)
- Reports Policy (PDF)
- Schedules Policy (PDF)
- Service Authorization Policy (PDF)
- Temporary 90 Day Visit Maintenance Policy (PDF)
- Temporary EVV Policies for COVID-19 (PDF)
- Training Policy (PDF)
- Visit Maintenance: Last Visit Maintenance Date Policy (PDF)
- Visit Maintenance Unlock Request Policy (PDF)
Cures Act EVV Expansion:
The policies below only apply to program providers and FMSAs delivering services subject to federal Cures Act EVV requirements.
Policy Handbook
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
- EVV Rights and Responsibilities – English PDF | Spanish PDF
Managed Care
- Form 1718 – MCO EVV Rights and Responsibilities – English PDF | Spanish PDF
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
State
- Texas Administrative Code, Title 1, Chapter 354, Subchapter O
- Texas Administrative Code, Title 40, Part 1, Chapter 41
- Texas Administrative Code, Title 40, Part 1, Chapter 49
- Texas Government Code, Section 531.024172
- Texas Human Resources Code, Section 161.086
Federal
Training
Frequently accessed training resources are listed below. See the HHSC EVV Training webpagefor additional resources.