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Revision 24-1; Effective Sept 12, 2024
Reason Codes are used to indicate why the program provider, FMSA or CDS employer is completing visit maintenance. A Reason Code consists of a Reason Code Number and a Reason Code Description. The Reason Code Number represents the overall issue for the need to complete visit maintenance on an EVV visit transaction. The Reason Code Description provides more detail about why the program provider, FMSA or CDS employer completed visit maintenance.
Program providers, FMSAs and CDS employers must select the most appropriate Reason Code Number and Description and must enter any required free text when completing visit maintenance in the EVV system.
See the current HHSC EVV Reason Codes on the EVV webpage for Reason Code Numbers, Reason Code Descriptions and free text requirements for each reason code.
The table below lists examples of when to use certain Reason Code Numbers and Descriptions.
| Reason Code | Reason Code Number and Description | Situation to Use Reason Code |
|---|---|---|
| 110 A | Service Delivery Exception – Service delivery differs from schedule | Only used when the program provider, FMSA or CDS employer has entered a schedule in the EVV system. |
| 110 B | Service Delivery Exception – Downward adjustment of Bill Hours | Used when the program provider, FMSA or CDS employer will be billing for less time than the actual time worked. Refer to Section 8000, Calculation of Bill Hours. |
| 110 D | Service Delivery Exception – Allowable overlapping visits | Used when one service provider is delivering services to two members at the same time or when two service providers are delivering services to one member. |
Examples of when to use other RCs are in HHSC EVV Policy Training.
Multiple Reason Codes
Program providers, FMSAs and CDS employers may use multiple Reason Code Numbers and Descriptions to provide details when completing visit maintenance on a single visit if they choose or if it is required by program policy.
Free Text Requirements
Free text is additional information the program provider, FMSA and CDS employer must enter to further describe the need for visit maintenance.
Program providers, FMSAs and CDS employers completing visit maintenance in the EVV system must enter more information in the free text field when using the following Reason Code Numbers and Descriptions:
- 210 I, Emergency,
- 600, Other.
EVV staff may review the free text entered in these Reason Codes during EVV compliance reviews. HHSC does not require free text when other Reason Code Numbers and Descriptions are used.
Program providers, FMSAs and CDS employers may enter free text for the other Reason Code Numbers and Descriptions if they choose.