Electronic Visit Verification (EVV)

Sign up to receive EVV email updates.

What is EVV?

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

21st Century Cures Act Updates

HHSC is implementing the federal 21st Century Cures Act (Section 12006).

The 21st Century Cures Act, or Cures Act, is a federal law that passed in 2016 requiring states to implement EVV for Medicaid personal care services and home health care services that require an in-home visit. States that do not implement EVV will receive reduced federal Medicaid funding.

  • 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.

Provider Communications

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, 11000 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

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, Reason Code Description and enter required free text when completing visit maintenance in the EVV system.

EVV Reason Codes

EVV Reason Codes Quick Reference Guide

The EVV: When to Use Reason Codes Numbers and Descriptions Effective Oct. 1, 2023 (PDF) quick reference guide includes examples of when to use each Reason Code Number and when to enter required free text.

EVV Reason Codes Crosswalk

Reference the EVV Reason Codes Crosswalk (PDF) to compare the different versions of reason codes.

Historical EVV Reason Codes

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

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

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

Home Health Care Services

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.

VMUR Instructions and Templates

VMUR Job Aids