Each time a change is made within the Electronic Visit Verification system, a reason code must be entered. A reason code is a standardized HHSC-approved three-digit number and description that is used during visit maintenance to explain the specific reason a change was made to an EVV visit record. There are preferred reason codes and non-preferred reason codes.
- Preferred reason codes indicate situations that are acceptable variations in the proper use of the EVV system.
- Non-preferred reason codes indicate situations where there was a failure to use the EVV system properly.
Providers must associate the most appropriate reason code with each change made in visit maintenance and enter any required free text in the comment section. A single visit may have more than one reason code associated with it. Once a reason code is saved to a visit, it cannot be deleted.
The health plans and HHSC will review reason codes use by their contracted provider agencies to ensure that preferred reason codes are not misused.
HHSC EVV Reason Codes Effective Sept. 1, 2019
Effective Sept. 1, 2019, updates have been made to EVV reason codes and free text requirements for HHSC Fee-for-Service and managed care organization programs. For more information, refer to the EVV Reason Code and Required Free Text Policy (PDF), as well as the updated reason codes below.