What is Electronic Visit Verification?
EVV is a computer-based system that electronically documents and verifies service delivery information, such as date, time, service type and location, for certain Medicaid service visits.
Programs and Services Required to Use EVV
Personal Care Services required to use EVV (PDF)
21st Century Cures Act Updates
HHSC is implementing the federal 21st Century Cures Act (Section 12006).
- Effective Jan. 1, 2021, EVV is required for Medicaid personal care services.
- Effective Jan. 1, 2024, EVV is required for Medicaid home health care services.
States that do not implement EVV will receive reduced federal Medicaid funding.
21st Century Cures Act has more information.
Compliance
HHSC and managed care organizations, the payers, conduct EVV compliance reviews to ensure program providers, Financial Management Services Agencies and Consumer Directed Services employers are in compliance with EVV requirements and policies.
EVV Compliance Job Aids
Refer to the EVV Policy Handbook section, 10000 EVV Compliance Reviews, for more information.
EVV Consumer Directed Services Option
EVV Consumer Directed Services Option has related resources and information.
Policies
Policy Handbook
Policy Handbook Revision Log
- Jan. 6, 2023, revisions (PDF)
- Sept. 1, 2022, revisions (PDF)
- June 1, 2022, revisions (PDF)
- March 1, 2022, revisions (PDF)
- Jan. 7, 2022, revisions (PDF)
- Nov. 1, 2021, revisions (PDF)
Proprietary Systems
Program providers and FMSAs may seek HHSC approval to use an EVV proprietary system instead of an EVV vendor system to comply with EVV requirements.
Read more about EVV Proprietary Systems.
Reason Codes
Program providers, FMSAs and CDS employers must select the most appropriate EVV Reason Code Number and Reason Code Description. When applicable, enter required free text.
Current HHSC EVV Reason Codes
Historical HHSC EVV Reason Codes
- EVV Reason Codes Effective Sept. 1, 2019 – Dec. 31, 2020 (PDF)
- EVV Reason Codes Effective July 1, 2017 – Aug. 31, 2019 (PDF)
Resources
Contact Guides
The following guides have contact information for EVV inquiries:
Getting Started with EVV
The guides below are for the following stakeholders to get started with EVV:
Best Practices
- Best Practices to Avoid EVV Claim Mismatches (PDF)
- HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF)
- EVV Billing Guidance for HCS and TxHmL (PDF): This document provides information and resources related to billing, which will help with EVV claims matching and in-home individualized skills and socialization claims.
- Best Practices for Temporary EVV Policies for COVID-19 (PDF) is a reference guide to help avoid recoupments related to Temporary EVV Policies for COVID-19, and only applies to visits with dates of service March 21 – Dec. 31, 2020.
Form 1718, Responsibilities and Additional Information (MCO)
Form 1718 is used by MCO service coordinators to inform Medicaid recipients of their requirements to comply with EVV (reference TAC §Section 354.4011).
Schedules
Program and Service Requirements for Schedules (PDF)
Statutes and Rules
- State
- Federal
Service Bill Codes Table
The EVV Service Bill Codes Table below provides current billing codes and details for EVV-relevant services in Long-term Care, Acute Care and Managed Care programs.
Program providers must use the appropriate Healthcare Common Procedure Coding System and modifier combinations to prevent EVV visit transaction rejections and EVV claim match denials.
Personal Care Services
- EVV PCS Service Bill Codes Table – version 11.2 (Excel)
- EVV PCS Service Bill Codes Table – version 11.2 (PDF)
Training Resources
HHSC EVV Training Resources has more information.
Visit Maintenance Unlock Request
An EVV Visit Maintenance Unlock Request allows a program provider, FMSA and CDS employer the opportunity to correct data element(s) on an EVV visit transaction(s) after the visit maintenance time frame has expired.
Program providers, FMSAs and CDS employers must follow the instructions on the EVV Visit Maintenance Unlock Request spreadsheets. Request emails must include a contact name, email address and phone number. Requests that are not sent securely could result in a Health Insurance Portability and Accountability Act (HIPAA) violation and the payer will deny the request.