9000, EVV Reason Code

Revision 22-4; Effective Sept 1, 2022

Reason Code Number(s) represent the overall issue for the need to complete visit maintenance on an EVV visit transaction. Reason Code Description(s) provide more detail about why visit maintenance was completed.

Program providers, FMSAs or CDS employers must select the most appropriate Reason Code Number(s), Reason Code Description(s) and must enter any required free text when completing visit maintenance in the EVV system.

If an EVV visit transaction is missing a clock in or clock out, program providers, FMSAs or CDS employers must use Reason Code Number 900 Non-Preferred, the appropriate Reason Code Description(s), and any other applicable EVV reason code. 

Program providers, FMSAs and CDS employers can use multiple Reason Code Numbers and Reason Code Descriptions to clarify more than one exception when completing visit maintenance on a single visit. 

See current HHSC EVV Reason Codes located on the EVV webpage for Reason Code Number(s), Reason Code Description(s) and required free text that must be documented for each reason code.

9010 EVV Reason Code Free Text Requirements

Revision 21-1; Effective Nov. 1, 2021

Free text is additional information the program provider, FMSA or CDS employer enters to further describe the need for visit maintenance.

Program providers, FMSAs or CDS employers completing visit maintenance in the EVV system must enter additional information in the free text field when:

  • The visit is missing a clock in time, a clock out time or both.
    • Enter the actual missing clock in or clock out time
  • Using the following Reason Code Numbers:
    • 131-Emergency
    • 600-Other
    • 900-Non-preferred

See the current HHSC EVV Reason Codes table for the free text requirement that must be documented for each reason code.

Compliance 

Failure to document required free text may result in enforcement actions including recoupment of associated claim(s). 
The Required Free Text Review may begin on or after the visit maintenance time frame has expired. This is to review the entry of required free text when a clock in or clock out is missing and when the following Reason Code Numbers are used: 

  • 131-Emergency
  • 600-Other
  • 900-Non-preferred

Refer to 10000 EVV Compliance Reviews for more information.  

The table below lists examples of required free text.

Reason for Visit Maintenance Reason Code Number Free Text Required (Examples)
Missing Clock In Time

900 A: Failure to call in

200 A: Alternative device ordered

  • “Actual clock in was 8:05 a.m. and actual clock out was 10 a.m.” or
  • “Actual start time was 8:05 a.m. and actual end time was 10 a.m.”
  • “8:05 a.m. and 10 a.m.”
Missing Clock Out Time

900 B: Failure to call out

300 A: Phone lines not working

  • “Actual clock in was 11 a.m. and actual clock out was 1 p.m.” or
  • “Actual start time was 11 a.m. and actual end time was 1 p.m.”
  • “11 a.m. & 1 p.m.”
Missing Clock In and Clock Out Time

900 C: Failure to call in and out

130 C: Ice or Snow storm

  • “Actual clock in was 10 a.m. and actual clock out was at 4 p.m. Due to Winter Storm Uri, service provider was unable to use the EVV system.” or
  • “10 a.m. 4 p.m. Due to Winter Storm Uri, service provider was unable to use the EVV system.”
Emergency 131
  • “When service provider arrived, member unresponsive.”
  • “Actual clock in was 10 a.m.”
Other 600
  • “EVV system not available. Actual clock in was 9 a.m. and actual clock out was 11 a.m.”
  • “Missing clock in or clock out time. Actual clock in was 9 a.m. and actual clock out was 11 a.m.”