EVV Claims Matching for HCS and TxHmL Billing Code Combinations Resumes July 1 - Updates and Resources

June 20, 2022

Electronic Visit Verification claims matching for all Service Group 21 Home and Community-based Services and Service Group 22 Texas Home Living billing code combinations resumes July 1. Refer to the May 25 notice.

In-home respite and in-home day habilitation service claims will now go through the EVV claims matching process. Community First Choice Personal Attendant Services/Habilitation service claims will resume the EVV claims matching process.

The EVV Personal Care Services Bill Codes Table includes details about billing code combinations. Refer to the 3/1/2022 entry in the revision history (rows 13 and 14 in Excel) and the Long-term Care Fee-for-Service section (CMS LTC FFS tab in Excel). The table is in Excel and PDF formats on the EVV webpage.

Resources to Prevent EVV Claim Mismatches

Refer to the HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF) for technical guidance and resources to prevent EVV claim mismatches.

The most common error HHSC has observed since May 1 is that program providers and Financial Management Services Agencies are not waiting for the EVV visit to be accepted at the EVV Aggregator prior to submitting the EVV claim. Check the EVV Portal to ensure the EVV visit transaction was accepted by the EVV Aggregator before submitting the EVV claim.

Email EVV Operations for questions.