15000, EVV Optional Services and Non-EVV Services
Revision 24-1; Effective Sept. 12, 2024
Only EVV required services must be documented in an EVV system. A program provider, FMSA or CDS employer may choose to document EVV optional services in the EVV system. They must not document non-EVV services in the EVV system.
Failure to document EVV required services in an EVV system will result in denied or recouped EVV claims. See 1400, Failure to use an EVV System, for more information.
15010 EVV Optional Services
Revision 24-1; Effective Sept. 12, 2024
An EVV optional service is a service commonly delivered during EVV-required services but does not require EVV data collection.
The service provider may use the EVV system to document service delivery, but the services are not EVV required services. EVV optional services are included in the Service Bill Code Tables and are indicated as optional in the EVV Required/Optional? column.
The visit transaction for an optional service can be collected in the state provided EVV system or an EVV proprietary system if optional services are included in the EVV proprietary system. When the program provider, FMSA or CDS employer has verified the optional service, they may transmit it to the EVV Aggregator. When these services are submitted on a claim for Medicaid reimbursement, they do not go through the EVV claims matching process.
Depending on the program requirements, the EVV system may replace paper timesheets for EVV optional services. Program providers, FMSAs and CDS employers must continue to follow program documentation requirements when they use the EVV system for EVV optional services.
The program provider, FMSA or CDS employer will determine how the service provider or the CDS employee will clock in and clock out of the EVV system when they deliver both EVV required services and EVV optional services on the same day.
EVV optional services are treated as non-EVV services if the program provider, FMSA or CDS employer does not use the EVV system to document them.
Based on the option chosen by the program provider or FMSA and CDS employer, the service provider or CDS employee will use one of the following options to document an EVV optional service that occurs during an EVV visit.
Option 1: Clock in and clock out of the EVV system for the EVV required service delivered before the EVV optional service begins. Clock in and clock out of the EVV system for the EVV optional service, then clock in and clock out of the EVV System for the EVV required service delivered after the EVV optional service ends.
- The program provider, FMSA or CDS employer is not required to conduct visit maintenance.
Option 2: Clock in and clock out of the EVV system for the EVV required service delivered before the EVV optional service begins. Clock in and clock out of the EVV system for the EVV required service delivered after the EVV optional service has ended.
- The program provider, FMSA or CDS employer is not required to conduct visit maintenance. They may conduct visit maintenance to create a visit transaction for the EVV optional service if desired. This will not impact the usage score.
Option 3: Remain clocked in to the EVV system while the EVV optional service is delivered.
- The program provider, FMSA or CDS employer must complete visit maintenance to specify the time spent delivering EVV optional services. The visit maintenance can be done in one of two ways:
- Downward adjust the bill hours to represent only the time for the EVV required service. This will not impact the usage score.
- Create separate visit transactions for each instance of EVV required service.
- The program provider, FMSA or CDS employer will change the bill time out of the original visit transaction to reflect the EVV required service delivered before the EVV optional service begins and create a new visit transaction for the EVV required service delivered after the EVV optional service ends. This will impact the usage score.
- The program provider, FMSA or CDS employer may create a visit transaction for the EVV optional service if desired. This will not impact the usage score.
Examples of recording EVV Optional Services time
Example 1: The service provider or CDS employee delivers an EVV required service from 8 a.m. to 10 a.m., an EVV optional service from 10 a.m. to 12 p.m., and an EVV required service from 12 p.m. to 1 p.m.
The service provider clocks in to the EVV system at 8 a.m. and clocks out of the EVV system at 1 p.m. The program provider, FMSA or CDS employer must conduct visit maintenance using one of the following methods:
- Downward adjust the bill hours from 5.00 to 3.00. This will not impact the usage score.
- Conduct visit maintenance to change the bill time out of the original visit transaction to 10 a.m. and create a new transaction for the EVV required service delivered from 12 p.m. to 1 p.m. This will impact the usage score.
- The program provider, FMSA or CDS employer may create a new visit transaction for the EVV optional service from 10 a.m. to 12 p.m., if they choose to use the EVV system for EVV optional services. Creating a visit transaction for an EVV optional service will not impact the usage score.
Example 2: The service provider or CDS employee delivers an EVV required service from 1 p.m. to 2 p.m., an EVV optional service from 2 p.m. to 4 p.m., and an EVV required service from 4 p.m. to 6 p.m.
The service provider clocks in to the EVV system at 1 p.m. and clocks out of the EVV system at 2 p.m. for the EVV required service delivered before the EVV optional service, and clocks in to the EVV system at 4 p.m. and clocks out of the EVV system at 6 p.m. for the EVV required service delivered after the EVV optional service. No visit maintenance is required for either of the visit transactions.
The program provider, FMSA or CDS employer may, if desired, complete visit maintenance to create a new visit transaction for the EVV optional service delivered from 2 p.m. to 4 p.m. Creating a visit transaction for an EVV optional service will not impact the usage score.
Example 3: The service provider or CDS employee delivers an EVV required service from 8 a.m. to 12 p.m., an EVV optional service from 2 p.m. to 4 p.m., and an EVV required service from 6 p.m. to 10 p.m.
The service provider clocks in to the EVV system at 8 a.m. and clocks out of the EVV system at 12 p.m. for the EVV required service delivered before the EVV optional service. The service provider clocks in to the EVV system at 2 p.m. and clocks out of the EVV system at 4 p.m. for the EVV optional service; and clocks in to the EVV system at 4 p.m. and clocks out of the EVV system at 6 p.m. for the EVV required service delivered after the EVV optional service. No visit maintenance is required for any of the visit transactions. This will not impact the usage score.
15020 Non-EVV Services
Revision 24-1; Effective Sept. 12, 2024
A non-EVV service is an authorized service that is not required to have an EVV visit transaction.
Program providers, FMSAs and CDS employers must not use the EVV system to document non-EVV services. Program providers, FMSAs or CDS employers should follow program documentation requirements for non-EVV services.
The program provider, FMSA or CDS employer will determine how the service provider or the CDS employee will clock in and clock out of the EVV system when they deliver non-EVV services and EVV services throughout the day.
Based on the option chosen by the program provider or FMSA and CDS employer, the service provider or CDS employee will use one of the following options to document a non-EVV service that occurs during an EVV visit.
Option 1: Clock in and clock out of the EVV system for the EVV required service delivered before the non-EVV service begins. Then clock in and clock out of the EVV system for the EVV required service delivered after the non-EVV service has ended.
- The program provider, FMSA or CDS employer is not required to conduct visit maintenance.
- The program provider, FMSA or CDS employer must complete visit maintenance to specify the time spent delivering non-EVV services according to program requirements. The visit maintenance can be done in two ways:
- Downward adjust the bill hours to represent only the time for the EVV required service. This will not impact the usage score.
- Create separate visit transactions for each instance of EVV required service.
- The program provider, FMSA or CDS employer will change the bill time out of the original visit transaction to reflect the EVV required service delivered before the non-EVV service begins. They will create a new visit transaction for the EVV required service delivered after the non-EVV service ends. This will impact the usage score.
Option 2: Remain clocked in to the EVV system while delivering the non-EVV service and document the amount of time spent on the non-EVV service.
- The program provider, FMSA or CDS employer must complete visit maintenance to specify the time spent delivering non-EVV services according to program requirements. The visit maintenance can be done in two ways:
- Downward adjust the bill hours to represent only the time for the EVV required service. This will not impact the usage score.
- Create separate visit transactions for each instance of EVV required service.
- The program provider, FMSA or CDS employer will change the bill time out of the original visit transaction to reflect the EVV required service delivered before the non-EVV service begins. They will create a new visit transaction for the EVV required service delivered after the non-EVV service ends. This will impact the usage score.
Examples for recording non-EVV time
Example 1: The service provider or CDS employee delivers an EVV required service from 8 a.m. to 10 a.m., a non-EVV service from 10 a.m. to 12 p.m.; and an EVV required service from 12 p.m. to 1 p.m.
The service provider clocks in to the EVV system at 8 a.m. and clocks out of the EVV system at 1 p.m. The program provider, FMSA or CDS employer must conduct visit maintenance using one of the following methods:
- Downward adjust the bill hours from 5.00 to 3.00. This will not impact the usage score.
- Conduct visit maintenance to change the bill time out of the original visit transaction to 10 a.m. and create a new transaction for the EVV required service delivered from 12 p.m. to 1 p.m. This will impact the usage score.
Example 2: The service provider or CDS employee delivers an EVV required service from 1 p.m. to 2 p.m., a non-EVV service from 2 p.m. to 4 p.m. and an EVV required service from 4 p.m. to 6 p.m.
The service provider clocks in to the EVV system at 1 p.m. and clocks out of the EVV system at 2 p.m. for the EVV required service delivered before the EVV optional service; then clocks in to the EVV system at 4 p.m. and clocks out of the EVV system at 6 p.m. for the EVV required service delivered after the EVV optional service. No visit maintenance is required for either of the visit transactions.
Program providers, FMSAs and CDS employers can review the reported non-EVV service time by accessing the Non-EVV Relevant Time Logged Report in the EVV system. The report will show the total hours worked for non-EVV services.
Note: Program providers, FMSAs or CDS employers must contact the state provided EVV system vendor or follow the EVV proprietary system vendor’s procedures to determine how to document non-EVV services for members with pre-scheduled visits.