7000, Clock In and Clock Out Methods

Revision 25-1; Effective March 12, 2025

A service provider or CDS employee must use an HHSC-approved clock in and clock out method to begin and end service delivery when providing EVV services to a member in the home or the community.

The state provided EVV system vendor offers three HHSC-approved clock in and clock out methods:

• Mobile method
• Home phone landline
• Alternative device

A PSO must offer one or more of the three HHSC-approved clock in and clock out methods listed above, one of which must be the mobile method. If the PSO only offers one clock in and clock out method, it must be the mobile method.

The state provided EVV system vendor must provide access to clock in and clock out methods at no cost to the member, program provider, FMSA, CDS employer, service provider, HHSC, MCO or TMHP, except for alternative devices as described in 7040, Alternative Device.

An EVV proprietary system vendor may charge the PSO for access to a specific clock in and clock out method. The PSO may not pass those costs on to the member, CDS employer, service provider, HHSC, MCO or TMHP.

If the clock in and clock out method malfunctions, the EVV system must allow the program provider, FMSA or CDS employer to manually enter EVV visits.

When the service provider or CDS employee clocks in and clocks out using an HHSC-approved method, the EVV system captures the following visit data:

• Service authorization, including the type of service provided
• Member data, including the name of the member who received the services
• Date and times the provider began and ended the service delivery visit
• Location, including the address, where the service is provided
• Name of the service provider who delivered the service

A PSO does not have to enter a service authorization for a service provider or CDS employee to clock in and clock out when using any approved clock in and clock out method. This does not eliminate the requirement to provide the required data described in 4400, Data Collection. The PSO must make sure all required data is included in the visit transaction or the claim may reject.

A program provider or FMSA who has chosen to use the state provided EVV system does not have to enter a service authorization for a service provider or CDS employee to clock in and clock out. The service provider or CDS employee may still clock in and clock out, however the visit will not auto-verify. This does not eliminate the requirement to provide the required data described in 4400, Data Collection. The program provider or FMSA must make sure all required data is included in the visit transaction or the claim may reject.

7010 Manually Entered EVV Visits

Revision 25-1; Effective March 12, 2025

A manually entered EVV visit transaction is an EVV visit that is manually entered into the EVV system when a service provider or CDS employee fails to use the EVV system to clock in when service delivery begins, clock out when service delivery ends or both.

A manual visit is used to record an EVV visit when a service provider or CDS employee does not use a HHSC-approved clock in or clock out method to record the EVV visit. A program provider, FMSA or CDS employer who performs visit maintenance must create a visit in the EVV system.

A program provider, FMSA or CDS employer must manually enter an EVV visit into the EVV system using visit maintenance when a service provider or CDS employee fails to clock in or out of the EVV system or an HHSC-approved clock in or clock out method is not available.

Manually entered visits will negatively impact the EVV Usage Score. Refer to 12000 Usage.

The program provider, FMSA or CDS employer must complete the following steps if the service provider or CDS employee fails to clock in or out of the EVV system for any reason:

• Verify the service provider or CDS employee delivered services per program policy and requirements.
• Manually enter the visit into the EVV system.
• Make sure all data elements listed in Section 4400, Data Collection, are included and correct.
• Complete visit maintenance using the most appropriate Reason Code Number(s), Reason Code Description(s), and free text, if applicable.
• Make sure the EVV visit transaction is accepted at the EVV Portal. This is applicable to program providers and FMSAs.

Program providers, FMSAs and CDS employers must complete all required visit maintenance, including manually entering visits, within the visit maintenance time frame.

7020 Mobile Method

Revision 25-1; Effective March 12, 2025

A service provider or CDS employee may use the mobile method to clock in and clock out of the EVV system in the home or in the community. If the mobile method is offered as a clock in and clock out method, the state provided EVV system vendor or EVV proprietary system vendor will supply a downloadable application for use on a smartphone or device with internet connectivity.

The EVV allowed geo-perimeter is within 250-1320 feet of the member’s home. The state provided EVV system vendor or PSO may select a geo-perimeter that meets their business needs if that geo-perimeter falls within the EVV allowed distance.

If a service provider or CDS employee clocks in or out within the geo-perimeter selected by the state provided EVV system vendor or PSO, the default service delivery location is the member home. The member home is the physical address where a member who receives EVV services resides. The service provider or CDS employee can select a different service delivery location if necessary.

If the service provider or CDS employee clocks in or clocks out beyond the geo-perimeter selected by the state provided EVV system vendor or PSO, the service provider or CDS employee must select a service delivery location.

Service Delivery Location options include:

• Member Home
• Family Home
• Neighbor’s Home
• Community

Note: If the service provider or CDS employee clocks in at the home, delivers services in the community and then clocks out at the home, the service delivery location would be member home.

Service providers may use their own personal smartphone or tablet, or a smartphone or tablet issued by the program provider.

Service providers must not use a member’s personal smartphone or tablet to clock in and clock out of the EVV system.

CDS employees may use:

• Their own personal smartphone or tablet;
• A smartphone or tablet issued by the FMSA;
• A smartphone or tablet owned by the CDS employer if permission is granted; or
• A smartphone or tablet purchased by the CDS employer for the CDS employee’s use.

The mobile method is the only clock in and clock out method the service provider or CDS employee may use when delivering EVV services in the community or when traveling out of state. Contact your program representative to determine if your service provider or CDS employee may deliver EVV services while the member is out of state.

The mobile method:

• Uses a secure login function for each user.
• Records the specific location at the exact time of clocking in and clocking out.
• Does not track location before clocking in, during service delivery or after clocking out.
• Does not use mobile device plan minutes and only uses minimal data.
• Does not store Protected Health Information (PHI) on the mobile device.
• Allows the service provider to login as well as clock in and clock out when an internet connection or a cellular network is not available, and automatically uploads the data when a connection is available.

Note: Program providers, FMSAs, the state provided EVV system vendor, PSOs and EVV proprietary system vendors must not sell location data or share it with any entity other than a Texas state government agency or contractor acting on behalf of a Texas state government agency.

Service providers and CDS employees:

• Must follow instructions from their program provider, FMSA or CDS employer to download and activate the mobile application.
• Must obtain their own unique login credentials from their program provider, FMSA or CDS employer.
• Must only use their own login credentials to access the mobile application.
• Must not share mobile application login credentials.
• May share the same mobile device to clock in and clock out of the EVV system if they each use their own mobile application login credentials.

The program provider, FMSA or CDS employer may contact the state provided EVV system vendor, the PSO or the EVV proprietary system vendor as applicable for a full list of mobile application specifications, including supported mobile devices.

HHSC, TMHP, the state provided EVV system vendor and MCOs are not liable for:

• Any cost incurred while using the mobile method.
• Any viruses on the mobile device.
• A hacked, broken, damaged, lost or stolen mobile device.
• A nonworking mobile device.

Service providers and CDS employees may also use the mobile application to view their EVV visits. They will not be able to view visit data for other service providers or any PHI.

7030 Home Phone Landline 

Revision 25-1; Effective March 12, 2025

The service provider or CDS employee may use the member’s landline to call the state provided EVV system vendor’s or PSO’s toll-free number to clock in and clock out if the member agrees. If the member does not allow the service provider or CDS employee to use their landline or if the member’s landline is frequently unavailable for the service provider or CDS employee to use, the service provider or CDS employee must use another approved clock in and clock out method.

Landline Requirements

• Program providers and FMSAs must follow the instructions from the vendor or EVV PSO to set up the landline.
• The landline must be the member’s home phone number or a landline in another location where the member frequently receives services, such as a family member’s home or a neighbor’s home.
  • The landline owner must give permission to the member and the service provider or CDS employee to use the phone for EVV.
• The phone must be a landline phone. It must not be an unallowable landline phone type. See Unallowable Landline Phone Type below.
  • A voice over internet protocol (VOIP) phone is allowable as a landline phone if it is a dedicated phone that requires fixed equipment at a specific address.

Program Providers and FMSAs are responsible for initial setup and maintenance of the landline in the EVV system. The program provider or FMSA must:

• Enter the member’s landline number in the EVV system before the service provider or CDS employee can use the landline to clock in and clock out.
• Enter one or more landline number if the member frequently receives services in an alternate location.
• Use the EVV Landline Phone Verification Report to verify the landline number in the EVV system.
• Make sure the landline number(s) listed in the member’s profile are current.
  • If the member frequently receives services in an alternate location, the service delivery location and service delivery address must be associated with the member’s profile. The service delivery location for a landline in an alternate location is restricted to the Family Home or Neighbor Home options.

The program provider or FMSA must update the member’s profile in the EVV system if the landline number used to clock in and clock out does not match.

Unallowable Landline Phone Type

An unallowable landline phone type is a mobile phone number or cellular enabled phone number. Phones used to clock in or clock out through the landline method must be a landline phone, and not a cellular phone or device.

Unallowable landline phone types include:

• Cellular phones
• Cellular enabled devices such as tablets and smart watches
• VOIP phone that does not require fixed equipment at a specific address

Numbers from phone carriers that provide mobile phone services only will always be identified as an unallowable phone type.

Note: If the service provider or CDS employee wants to use a cell phone or tablet, they must use the mobile method.

Identification of an Unallowable Landline Phone Type

Program providers, FMSAs and CDS employers must use the EVV Landline Phone Verification Report in the EVV system to identify an unallowable landline phone type as mobile. Payers also use this report to conduct EVV Landline Phone Verification Reviews. Refer to 11020 EVV Landline Phone Verification Reviews.

Action must be taken if the program provider, FMSA, CDS employer or payer identify an unallowable phone type.

Program Provider Required Actions

When an unallowable phone type is identified, program providers must:

• Verify and document that the phone type is an allowable phone type; or
• Remove the unallowable landline phone type from the EVV system as the member’s home phone landline and make sure a valid landline or another approved clock in and clock out method is used.

Program providers must follow any actions required by the payer in a notice of noncompliance.

FMSA and CDS Employer Required Actions

When an unallowable phone type is identified, FMSAs must tell the CDS employer that the phone number is an unallowable landline phone type and:

• Work with the CDS employer to verify and document that the phone type is an allowable phone type; or
• Remove the unallowable landline phone type from the EVV system as the member’s home phone landline and work with the CDS employer to make sure a valid landline number or another approved clock in and clock out method is used.

When an unallowable phone type is identified, CDS employers must take one of the following actions:

• provide documentation to the FMSA that demonstrates the current landline number is an allowable phone type;
• provide a valid landline number to the FMSA; or
• choose another approved clock in and clock out method for the CDS employee to use and inform the FMSA of the new method.

FMSAs and CDS employers must follow any actions required by the payer in a notice of noncompliance.

Documentation

When requested by the payer, program providers and FMSAs must provide documentation to:

• demonstrate that the phone number is from an allowable phone type; or
• demonstrate that the service provider or CDS employee no longer uses an unallowable landline phone type.

Examples of documentation from an external source that shows the phone number is an allowable landline phone type may include screenshots or printouts from:

• White Pages
• Free carrier look-up service
• Reverse phone lookup

If the phone number is from an unallowable phone type, program providers and FMSAs must provide documentation that shows the service provider or CDS employee no longer uses an unallowable landline phone type. Acceptable documentation includes:

• A screenshot of the member profile that shows another approved clock in and clock out method is used.
• Verification from the EVV system that shows an alternative device was ordered for the member, if applicable.

7040 Alternative Device 

Revision 25-1; Effective March 12, 2025

An alternative device is an HHSC-approved electronic device that allows a service provider or CDS employee to clock in and clock out of the EVV system from the member’s home.

A program provider, CDS employer or service provider must explain to the member the purpose of the alternative device and how the alternative device works.

The alternative device produces codes that identify the precise date and time service delivery begins and ends. Codes from alternative devices provided by the state provided EVV system vendor expire seven days from the date of the EVV visit. Codes from alternative devices must be entered into the EVV system before they expire by calling a toll-free number or using the mobile device application provided by the state provided EVV system vendor.

The service provider or CDS employee may use any phone type, such as a landline or mobile phone, to call the toll-free number and enter the alternative device codes. A service provider may not use a member’s mobile phone.

A CDS employee may use a CDS employer’s mobile phone with the CDS employer’s permission.

Note: A proprietary system operator (PSO) may offer different types of alternative devices. All alternative devices must support the collection of critical data elements. HHSC must approve any alternative device used by the PSO before use. Refer to 5060 EVV Proprietary System General Operations and 4400 Data Collection.

The alternative device must always remain in the member’s home even during an evacuation. If the alternative device does not remain in the home, visit transactions may be subject to recoupment and the payer may make a Medicaid fraud referral to the HHS Office of the Inspector General.

The program provider or FMSA must make sure the alternative device is returned to the appropriate entity when the equipment is no longer used.

Limitations on the Number of Alternative Devices Available to Program Providers and FMSAs from the State Provided EVV System Vendor

HHSC limits the number of free alternative devices each program provider and FMSA may order from the state provided EVV system vendor for assignment to members. The number of free alternative devices available to each program provider or FMSA is calculated based on the program provider or FMSA’s member census and is capped at the greater of one alternative device or 7.5% of their member census.

Some examples of the calculation of the number of free alternative devices a program provider or FMSA may order are:

• A program provider or FMSA with a census of 1,525 members will be able to order up to 114 free alternative devices available for assignment to members, which would be 1,525 x 7.5% = 114.4, rounded to 114.
• A program provider or FMSA with a census of 1,956 members will be able to order up to 147 free alternative devices available for assignment to members, which would be 1,956 x 7.5% = 146.7, rounded to 147.
• A program provider or FMSA with a census of eight members will be able to order one free alternative device for assignment to a member, which would be 8 x 7.5% = .6, rounded to one.
• A program provider or FMSA with a census of five members will be able to order one free alternative device for assignment to a member, which would be 5 x 7.5% = .4, rounded to zero; however, each program provider or FMSA will have access to at least one free alternative device.

HHSC may periodically review and adjust the number of free alternative devices each program provider or FMSA may order, as necessary.

Note: The limitation policy on the number of alternative devices does not currently apply to program providers or FMSAs who have been approved as a PSO.

Program providers and FMSAs who use the state provided EVV system may, if they chose, purchase additional alternative devices from the state provided EVV system vendor. The state provided EVV system vendor will set the purchase price for the additional alternative devices.

Program providers and FMSAs must develop internal policies on the equitable distribution of both free and purchased alternative devices.

If a member is eligible for an alternative device but does not receive one based on the FMSA’s internal policies, a CDS employer may choose to use funds from the Employer Support Services portion of their budget to purchase an alternative device.

Ordering Alternative Devices from the State Provided EVV System Vendor

Program providers and FMSAs who use the state provided EVV system may only order an alternative device when the member meets certain criteria. The criteria apply if a program provider or FMSA uses one of the free alternative devices or purchases an alternative device from the state provided EVV system vendor.

Before a program provider or FMSA orders an alternative device, they must make sure the member or consumer directed services (CDS) employer meets certain criteria to be assigned an alternative device. For members who use the Agency Option or Service Responsibility Option (SRO), an alternative device may be assigned to a member if:

• the member’s service provider does not have a smartphone or tablet; and
• the member does not have a landline or does not allow the service provider to use their landline.

For members who use the consumer directed services (CDS) option, an alternative device may be assigned to a CDS employer if:

• the CDS employee does not have a smartphone or tablet;
• the CDS employer does not have a landline or does not allow the CDS employee to use their landline; and
• the CDS employer does not allow the CDS employee to use their smart phone or tablet.
  • Note: If the CDS employer purchased or pays for a landline, smartphone or tablet with CDS funds from their Employer Support Services budget, they may not refuse to allow the CDS employee to use the smartphone or tablet.

Program providers and FMSAs should submit a request to order an alternative device per the state provided EVV system vendor’s ordering process on the HHAeXchange website within five business days of determining a member meets the criteria. They must follow the state provided EVV system vendor’s process for ordering an alternative device.

The state provided EVV system vendor has five business days to process and ship the alternative device to the requestor upon receipt of a complete order, up to the total number of alternative devices available for a program provider and FMSA. Depending on the shipping method, it may take additional days to deliver the order.

Program providers, FMSAs on behalf of CDS employers or CDS employers may use the state provided EVV system vendor’s electronic ordering method to:

• order a new or replacement alternative device;
• track orders for the alternative device;
• manage, assign and un-assign alternative devices; and
• manage shipping addresses.

If a clock in or clock out method is not available for use before the delivery of an alternative device, the service provider or CDS employee must document the EVV visit and submit service delivery documentation to the program provider or FMSA according to program policy. The program provider, FMSA or CDS employer must manually enter visit data in the EVV system within the visit maintenance time frame. Refer to Section 7010, Manually Entered EVV Visits.

Installing Alternative Devices

The program provider, CDS employer, service provider or CDS employee must:

• ask the member where to place the alternative device in the member’s home. The alternative device must:
  • be in a location where it is always accessible to the service provider or CDS employee;
  • be placed in a location that will not result in damage to the alternative device;
  • not be placed in a location that may be dangerous to a member or cause damage to the member’s home; and
• install the alternative device by placing the device in the member’s home for use by the service provider or CDS employee.

Malfunctioning Alternative Devices

The service provider or CDS employee must tell the program provider or CDS employer immediately if the alternative device malfunctions or fails to generate codes.

Alternative devices that malfunction will be replaced by the state provided EVV system vendor free of charge if it is determined the issue with the alternative device is out of the control of the program provider, FMSA, CDS employer or member. The malfunctioning alternative device must be returned before the replacement is shipped. Contact the state provided EVV system vendor to request a replacement.

When the service provider tells the program provider or the CDS employee tells the CDS employer the alternative device has malfunctioned:

• The service provider or CDS employee must use another clock in and clock out method to document the EVV visit per program requirements or submit service delivery documentation to the program provider, FMSA or CDS employer for manual entry of an EVV visit. If the program provider, FMSA or CDS employer creates a manual visit transaction because of a malfunctioning device they should use Reason Code 210-F, Alternative device not available. Refer to 1400 Failure to use an EVV System.
• The program provider, FMSA or CDS employer that uses the state provided EVV system must contact the state provided EVV system vendor to report the malfunctioning device and order a replacement alternative device within five business days of being notified the device is malfunctioning.
• A program provider or FMSA approved as a PSO must order a replacement alternative device within five business days of being told the device is malfunctioning.

If the alternative device is lost or damaged because of deliberate action or negligence of the member, service provider or CDS employee, the program provider or FMSA may be charged for a replacement. HHSC, TMHP and the state provided EVV system vendor are not responsible for lost or damaged alternative devices.

If the alternative device is damaged or lost by a member, the program provider, FMSA or CDS employer must request a meeting as required by program policy to discuss the use of the alternative device with the member. The program provider or FMSA must document in the member’s case file each time the alternative device is damaged or lost.

If the program provider, FMSA or CDS employer fails to complete the actions required for a lost or damaged device, they may be responsible for the lost or damaged alternative device.

Return of Alternative Devices

The program provider or FMSA must return the alternative device to the state provided EVV system vendor when they no longer need a device for a specific member, such as when the member no longer needs an alternative device, or they transfer to a new program provider or FMSA.

It is the responsibility of the program provider or FMSA to get the device back from the member and they must not charge the member for the return of the alternative device.

Reduction of Alternative Devices

Beginning Sept. 1, 2025, HHSC will reduce the number of visit transactions that a program provider, FMSA, CDS employer or PSO may make using an alternative device. The reduction will occur over three fiscal years. From Sept. 1, 2028, going forward, a program provider, FMSA, CDS employer or PSO must not make more than 5% of their visit transactions using an alternative device. The allowable percent of visit transactions a program provider, FMSA, CDS employer or PSO may make using an alternative device are:

7050 Using Multiple Clock In and Clock Out Methods

Revision 24-1; Effective Sept. 12, 2024

A service provider or CDS employee may use multiple clock in and clock out methods.

Examples of using one method to clock in and out for a single EVV visit happens when the service provider or CDS employee:

• Clocks in and out using the mobile method.
• Clocks in and out using a home phone landline.
• Clocks in and out using an alternative device.

Examples of using multiple methods to clock in and out for a single EVV visit happens when the service provider or CDS employee:

• Clocks in using a home phone landline and clocks out using the mobile method.
• Clocks in using the mobile method and clocks out using a home phone landline.

Program providers and CDS employers may contact the state provided EVV system vendor or PSO for more information about which methods can be used together or for EVV system training.

7060 EVV Services Delivered Outside the Member’s Home

Revision 25-1; Effective March 12, 2025

The mobile method is the only HHSC-approved clock in and clock out method when an EVV service begins or ends in the community. Using the mobile method for clocking in and out in the community avoids negative impacts to the EVV Usage Score. Refer to 11010 EVV Usage Reviews for more information.

If a service provider or CDS employee is unable to use the mobile method when an EVV service begins or ends in the community, they must document visit data per program policy and 1400 Failure to Use an EVV System.

Program providers and CDS employers may contact the state provided EVV system vendor or their EVV proprietary system vendor for more information and EVV system training.

7070 Multiple EVV Visit Transactions

Revision 25-1; Effective March 12, 2025

Overnight Shifts

Overnight shifts begin on one date of service and end on the next date of service. If a service provider’s shift begins before midnight and ends after midnight, their clock in and clock out transactions will be on different days. The EVV system will automatically split the shift into two separate EVV visit transactions for visit transactions the service provider or CDS employee makes using an approved clock in and clock out method. Service providers and CDS employees will not be required to clock in and clock out multiple times during an overnight shift. Note: Each visit will be subject to the rounding rules described in 8020 Rounding.

Before scheduling overnight visits, confirm the requirements with program staff.

For example, Suzy works an overnight shift from 10 p.m. to 6 a.m. She clocks in at 10 p.m. when she begins work and clocks out at 6:08 a.m. when she finishes work the next morning The EVV system will automatically split Suzy’s overnight shift into two separate visit transactions:

• 10 p.m. to 11:59 p.m. This visit is 1 hour and 59 minutes and will round to 2 hours,
• 12 a.m. to 6:08 a.m. This visit is 6 hours and 8 minutes and will round to 6.25 hours.

If multiple service providers cover the overnight shift, and none of the service providers’ shifts are scheduled to begin before midnight and end after midnight, the EVV system does not need to split the visit. However, if a service provider clocks in or clocks out before or after their scheduled shift, and the clock in is before midnight and the clock out is after midnight, the system will automatically split the visit into two visits.

In the following scenarios Tricia is scheduled from 10 p.m. to midnight and Cindy is scheduled from midnight to 6 a.m.

• Scenario 1: Tricia clocks in at 9:58 p.m. and clocks out at 12:02 a.m. The EVV system will split Tricia’s visit into two transactions:
  • 9:58 p.m. to 11:59 p.m. This visit is 2 hours and 1 minute and will round to 2 hours.
  • 12:00 a.m. to 12:02 a.m. This visit is 2 minutes and will round to zero hours.
• Scenario 2: Tricia clocks in at 9:57 p.m. and clocks out at 11:58 p.m. The visit does not cross over midnight so the EVV system will not split the visit.
  • This visit is 2 hours and 1 minute and will round to 2 hours.
• Scenario 3: Cindy clocks in at 11:58 p.m. and clocks out at 6:09 a.m. The EVV system will split the visit into two transactions:
  • 11:58 p.m. to 11:59 p.m. This visit is 1 minute and will round to zero hours.
  • 12:00 a.m. to 6:09 a.m. This visit is 6 hours and 9 minutes and will round to 6.25 hours.
• Scenario 4: Cindy clocks in at 12:03 a.m. and clocks out at 6:01 a.m. The visit does not cross over midnight so the EVV system will not split the visit.
  • This visit is 5 hours and 58 minutes and will round to 6 hours.

Overlapping EVV Visit Transactions

When the service dates and times are the same or overlap for each service provider, the visit transactions may not auto-verify. If the visit does not auto-verify, the program provider, FMSA, CDS employer or PSO must conduct visit maintenance so the EVV system will transmit the visit transaction to the Aggregator. Note: If a schedule is entered in the EVV system, the visit transactions must match the schedule regardless of the services and service delivery location. Visit transactions that do not match the schedule will require visit maintenance as described in 4600, Schedules.

Before scheduling overlapping visits, confirm with program staff they are allowable in the specific program.

Some programs allow members to have more than one service provider at a time to meet their needs. For example, a member may:

• Need two service providers to help them safely receive services.
• Be authorized for two different services that may be provided at the same time.

The following are some examples of overlapping visits when there are multiple service providers:

• Scenario 1: Sarah is authorized for personal care services and requires two service providers to safely get out of bed in the morning. Cindy, her primary service provider, works from 8 a.m. to 12 p.m. Once Sarah is out of bed, Cindy can deliver Sarah’s remaining personal care services without assistance. Tricia comes in from 8 a.m. to 8:30 a.m. to assist Cindy getting Sarah out of bed. Both Cindy and Tricia will deliver services to Sarah from 8 a.m. to 8:30 a.m., so there will be overlapping visits.
  • If Cindy and Tricia both select the Member Home option as the service delivery location:
    • The EVV system will allow the overlapping visits because the service and service delivery location are the same.
    • The visit transactions will auto-verify if there are no other data errors.
    • Visit maintenance is not required.
  • If Cindy selects the Member Home option as the service delivery location and Tricia accidentally selects an incorrect service delivery location option, such as Neighbor Home:
    • The EVV system will flag the visit transactions for review because the service delivery location is different in each visit transaction.
    • The program provider, FMSA, CDS employer or PSO must complete visit maintenance on Tricia’s visit transaction to correct the service delivery location and use Reason Code 310-E Incorrect service delivery location.
• Scenario 2: Jim is authorized for personal care services and requires two service providers to assist with certain tasks while he is in the community. Patrick, his primary service provider, works from 10 a.m. to 4 p.m. to deliver services both in the home and the community. He begins delivering services in the home and at 11:30 a.m., Jim and Patrick go out in the community. Tim joins them to assist Patrick to deliver services from 1 p.m. to 2:30 p.m. At 2:30, Jim and Patrick return to Jim’s house and Tim finishes his shift. Patrick will use the Member Home option as the service delivery location to clock in and clock out  and Tim will use the Community option as the service delivery location to clock in and clock out.
  • Because the service delivery location is different in each visit transaction, the EVV system will not allow the overlapping visits and will flag the visit transactions for review.
  • The program provider, FMSA, CDS employer or PSO must complete visit maintenance on both Patrick’s and Tim’s visit transactions and use Reason Code 110-D Allowable overlapping visits.
• Scenario 3: Betty is authorized for personal care services and nursing services. Betty’s personal care services provider Sally works 8 a.m. to 2 p.m. Patricia comes to Betty’s house from 10 a.m. to 11 a.m. to deliver the authorized nursing services. Both Sally and Patricia will deliver services to Betty from 10 a.m. to 11 a.m. so the visits will overlap.
  • If Sally and Patricia both select the Member Home option as the service delivery location:
    • The EVV system will allow the overlapping visits because the service delivery location is the same in each visit transaction,
    • The visit transactions will auto-verify if there are no other data errors.
    • Visit maintenance is not required.
  • If Sally selects the Member Home option as the service delivery location and Patricia accidentally selects an incorrect service delivery location such as the Community option:
    • The EVV system will flag the visit transactions for review because the service delivery location is different in each visit transaction.
    • The program provider, FMSA, CDS employer or PSO must complete visit maintenance on Patricia’s visit transaction to correct the service delivery location and use Reason Code 310-E Incorrect service delivery location.
• Scenario 4: Tiffany lives with her family. She requires personal care, nursing and occupational therapy. Because her family provides her personal care, only nursing and occupational therapy are included on her service plan. Tiffany has a regular activity in the community, which is when Sam provides occupational therapy. Tiffany’s service plan also includes periodic respite for times when her family members are unavailable. Becky, the respite service provider, begins work at 8 a.m. in Tiffany’s home, then takes her to her community activity at 1 p.m. Sam joins them in the community and provides occupational therapy from 1:30 p.m. to 2 p.m. At 3 p.m. Becky and Tiffany return to Tiffany’s home. Becky finishes work at 5 p.m. Becky will use the Member Home option as the service delivery location to clock in and clock out and Sam will use the Community option as the service delivery location to clock in and clock out.
  • Because the service delivery location is different in each visit transaction, the EVV system will not allow the overlapping visits and will flag the visit transactions for review.
  • The program provider, FMSA, CDS employer or PSO must complete visit maintenance on both Becky’s and Sam’s visit transactions and use Reason Code 110-D Allowable overlapping visits.

There may also be circumstances where two or more members live in the same home and one service provider delivers services to all members. This can include:

• A married couple
• Siblings
• A parent and an adult child
• Unrelated adults who share a residence

Note: This does not apply to members who live in a residential setting because these are not EVV required services. Residential settings are licensed or certified settings that provide a 24-hour living arrangement to more than one member.

The following are some examples of overlapping visits when there are multiple members and one service provider:

• Scenario 1: Pete and Sue are married, live together and are both authorized for personal care services. One service provider, Jessica, delivers services to both Pete and Sue. Jessica will clock in and clock out separately for Pete and Sue, which results in overlapping visits.
  • If Jessica selects the Member Home option as the service delivery location for both Pete’s and Sue’s visit transactions:
    • The EVV system will allow the overlapping visits because the service delivery location is the same in each visit transaction.
    • The visit transactions will auto-verify if there are no other data errors.
    • Visit maintenance is not required.
  • If Jessica selects the Member Home option as the service delivery location for Pete and accidentally selects an incorrect service delivery location such as the Community option for Sue:
    • The EVV system will flag the visit transactions for review because the service delivery location is different in each visit transaction.
    • The program provider, FMSA, CDS employer or PSO must complete visit maintenance on the visit transaction for Sue to correct the service delivery location and use Reason Code 310-E Incorrect service delivery location.
• Scenario 2: Dan and Ted are brothers who live together. Ted is authorized for Home and Community-based Services (HCS) Community First Choice (CFC) personal assistance services/habilitation services (PAS/HAB). Dan is authorized for Community Living Assistance and Support Services (CLASS) CFC PAS/HAB. One service provider, George, delivers services to both Dan and Ted. George will clock in and clock out separately for Dan and Ted, which results in overlapping visits.
  • If George selects the Member Home option as the service delivery location for both Dan’s and Ted’s visit transactions:
    • Visit maintenance may not be required. Contact your EVV system vendor to determine if visit maintenance will be required in this circumstance.
    • If your EVV system requires visit maintenance use Reason Code 110-D Allowable overlapping visits.
  • If George selects the Member Home option as the service delivery location for Dan and accidentally selects an incorrect service delivery location such as the Community option for Ted:
    • The EVV system will flag the visit transactions for review because the service delivery location is different in each visit transaction.
    • The program provider, FMSA, CDS employer or PSO must complete visit maintenance on both visit transactions:
      • Use Reason Code 110-D Allowable overlapping visits for Dan’s visit transaction.
      • Correct the service delivery location on Ted’s visit transaction and use both Reason Code 310-E Incorrect service delivery location and 110-D Allowable overlapping visits.