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. Texas Health and Human Services Commission (HHSC) determines when a program provider, Financial Management Services Agencies (FMSA) or Consumer Directed Services (CDS) employer must use EVV based on the services delivered. EVV is required for all programs and services listed in the Programs and Services Required to Use EVV .
Electronic Visit Verification (EVV)
-
EVV Policies
Policy Handbook
Policy Handbook Revisions
- October 1, 2023 - EVV Policy Handbook Revision
- January 2023 - EVV Policy Handbook Revisions
- September 2022 - EVV Policy Handbook Revisions
- June 2022 - EVV Policy Handbook Revisions
- March 2022 - EVV Policy Handbook Revisions
- January 2022 - EVV Policy Handbook Revisions
EVV Reasons Codes
- EVV Reason Codes Effective Jan. 1, 2021, through Sept. 30, 2023 (PDF)
- EVV Reason Codes Effective Oct. 1, 2023, and after (PDF)
EVV Reasons Codes Codewalk
Reference the EVV Reason Codes Crosswalk (PDF) to compare the different versions of reason codes.
Historical EVV Reasons Codes
- EVV Reason Codes Effective Sept. 1, 2019 – Dec. 31, 2020 (PDF)
- EVV Reason Codes Effective July 1, 2017 – Aug. 31, 2019 (PDF)
Best Practices
- Best Practices to Avoid EVV Claim Mismatches (PDF)
- HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF)
- 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.
Compliance Job Aids
Refer to the EVV Policy Handbook section, 10000 EVV Compliance Reviews, for more information.
Policy Guidance
- EVV Visit Transaction Rejection Guide
- Guidance for FMSAs when CDS Employers Do Not Perform EVV Responsibilities
VMUR Job Aids
-
EVV Training
Checklist:
EVV Training Requirements Checklists (PDF)
Training Websites:
Blue Cross and Blue Shield of Texas (BCBSTX) EVV Training
Getting Started with EVV Trainings
Texas Medicaid and Healthcare Partnership (TMHP) EVV Portal Training
TexMedConnect:
TexMedConnect is an online application within TMHP that lets providers file claims, check claims status, confirm client eligibility, and more. There are two versions of TexMedConnect—acute-care and long-term care.
For more information about how to setup and use the acute care version of TexMedConnect, providers can refer to:
- TexMedConnect–Acute Care Manual
- TexMedConnect User Guide for Managed Care Organization (MCO) Long Term Services and Supports (LTSS) Providers
- STAR Kids MCO Training Manual – TMHP Web Security and Permissions
For more information about how to setup and use the long-term care version of TexMedConnect, providers can refer to:
-
EVV Notices
- 09/25/2023 EVV: HHAeXchange Onboarding and User Credentials
- 09/25/2023 Cures Act Home Health Care Services: EVV HHCS Service Bill Codes Table Update
- 09/22/2023 Electronic Visit Verification Data Access and Conversion
- 09/22/2023 Current EVV Users Must Complete Visits Maintenance Before They Lose Access on Dec. 22, 2023
- 09/21/2023 Registration Available for HHSC EVV Policy Training Webinars for Programs Providers, FMSAs and CDS Employers
- 09/20/2023 Correction to EVV Policy Updates Now Available for Alternative Devices
- 09/18/2023 EVV: HHAeXchange Onboarding and user Credentials
- 09/14/2023 Publication of Electronic Visit Verification (EVV) Proposed Texas Administrative Code (TAC) Rules
- 09/13/2023 EVV Policy Updates Now Available for Alternative Devices
- 09/13/2023 EVV Portal Updates and Reminder for Required Training
- 09/08/2023 EVV CDS Employers and CDS Employees Can Register for In-Person HHAeXchange System User Training
- 09/07/2023 Register for Sept. 14 FMSA Quarterly Webinar
- 09/07/2023 EVV Portal Updates and Reminder for Required Training
- 09/05/2023 Ordering EVV Alternative Devices from HHAeXchange
- 09/05/2023 EVV Take Action Now: Onboard with HHAeXchange
- 09/05/2023 EVV Systems AuthentiCare and Vesta Available for Use Through Sept. 30, 2023
- 09/01/2023 Register Now for HHAeXchange EVV System User Training
- 08/31/2023 Updated: EVV – HHAeXchange Users Must Register and Complete System User Training
- 08/30/2023 Correction to Qualifications to Purchase an EVV Alternative Device
- 08/29/2023 EVV Compliance Grace Period Overview for Cures Act Personal Care Services and Home Health Care Services
- 08/29/2023 Qualifications to Purchase an EVV Alternative Device Policy
- 08/21/2023 EVV Reminder: Onboard with HHAeXchange by Aug. 31
- 08/21/2023 Update: EVV Alternative Device Policy
- 08/03/2023 System Maintenance Outage Scheduled for September 1–5, 2023
- 08/03/2023 EVV Begin the Onboarding Process with HHAeXchange
- 08/02/2023 Correction: EVV System Integration to HHAeXchange
- 08/01/2023 HHAeXchange Third-Party EVV System Integration
- 07/31/2023 EVV Contact Information Guides
- 07/31/2023 EVV Updates Now Available for Policy, Reason Codes, Visit Maintenance Unlock Request, and EVV Policy Training
- 07/31/2023 HHAeXchange Provider Onboarding Details
- 07/25/2023 FMSAs Must Notify CDS Employers of EVV System Selection by Aug. 1, 2023
- 07/25/2023 EVV Portal and Training Updates for the EVV Proprietary System Request Form
- 07/21/2023 TMHP Live Chat Support Implementing September 5, 2023
- 07/21/2023 Phone System Improvements Implementing September 5, 2023
- 07/20/2023 Attention Home Health Care Providers - EVV Reminder
- 07/17/2023 Upcoming EVV Alternative Device Policy
- 07/17/2023 EVV Compliance Grace Period for EVV Usage and Home Phone Landline
- 07/14/2023 Register for Initial EVV Policy Training Webinar for Program Providers and FMSAs
- 07/13/2023 EVV Portal and Training Updates for the EVV Proprietary System Request Form Effective July 13, 2023
- 07/13/2023 Changes and Updates to the Long Term Services and Supports Billing Matrix and Crosswalk
- 07/06/2023 Clarification Update: EVV Proprietary System Operator Waitlist
- 07/03/2023 Register for HHAeXchange Information Sessions for New EVV System
- 06/29/2023 Register for EVV Policy Training for CDS Employers
- 06/26/2023 EVV Proprietary System Operator Waitlist Is Full, Ensure Required Information is Submitted if Participating in Expedited Path
- 06/20/2023 Next Steps and Timeline for Transition to HHAeXchange
- 05/15/2023 EVV Resources Updates
- 05/08/2023 EVV Vendor Transition Overview
- 05/05/2023 Electronic Visit Verification Contract Awarded to Accenture and HHAeXchange
- 05/05/2023 Register for May 23 Quarterly FMSA Webinar
- 05/05/2023 EVV Portal Webinar Recordings and Q&A Documents Now Available for Program Providers and FMSAs
- 05/03/2023 Revised Consumer Directed Services Forms 1720 and 1722
- 04/27/2023 EVV Form 1718, Responsibilities and Additional Information (MCO), Updated
- 04/21/2023 Clarification Update: In-Home Individualized Skills and Socialization Claims Will Deny without EVV on May 1
- 04/20/2023 In-Home Individualized Skills and Socialization Claims Will Deny without EVV on May 1
- 04/17/2023 Reminder: EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023
- 03/30/2023 Update to "EVV Visit Transactions Rejecting Ex0002c"
- 03/22/2023 Session 4 ORR Schedules Added to TMHP EVV Proprietary Systems Web Page
- 03/17/2023 Cures Act Home Health Care Services: EVV HHSC Service Bill Codes Table Update
- 02/24/2023 Registration Available for EVV Portal Webinars
- 02/13/2023 EVV Visit Transactions Rejecting with Ex0002C
- 02/09/2023 EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023
- 02/06/2023 Resolved: Electronic Visit Verification Visit Transactions Processing Delay
- 02/03/2023 Electronic Visit Verification Visit Transactions Processing Delay
- 01/20/2023 EVV Visit Transaction Guide Update
- 01/17/2023 Reminder: Proposed Changes to EVV TAC Rules Posted for Informal Comment — Due by Jan. 20
- 01/17/2023 EVV Personal Care Services Bill Codes Updates for HCS and TxHmL
- 01/17/2023 EVV Portal and Training Updates
- 01/13/2023 EVV 21st Century Cures Act Web Page Updates Starting January 13, 2023
- 01/13/2023 EVV Portal and Training Updates January 13, 2023
- 01/11/2023 HHSC Publishes Individualized Skills and Socialization Automatic Service Authorizations and Electronic Visit Verification
- 01/10/2023 Proposed Changes to EVV Texas Administrative Code Rules Posted for Informal Comment – Due by Jan. 20
- 01/10/2023 EVV Policy Handbook Revision and Training Updates
- 12/15/2022 EVV Guidance on Program and Service Requirements for Schedules
- 12/14/2022 EVV Operational Readiness Sessions and EVV Business Rules for Proprietary Systems Version 3.0
- 12/09/2022 EVV Training Updates
- 11/21/2022 Reminder for STAR+PLUS, STAR Kids and STAR Health: New EVV Bill Codes and Modifier Combinations Effective Dec. 1
- 11/21/2022 Cures Act Home Health Care Services: EVV Services Updates and Service Bill Codes Table Now Available
- 10/31/2022 EVV PCS Bill Code Table Updates: STAR+PLUS, STAR Kids, STAR Health
- 10/25/2022 Potential Electronic Visit Verification (EVV) Changes Coming in 2023
- 10/24/2022 EVV Cures Act Home Health Care Services Implementation Confirmed for Jan. 1, 2024
- 10/11/2022 Reminder: Annual Electronic Visit Verification (EVV) Policy Training Webinars for Consumer Directed Services (CDS) Employers
- 08/29/2022 Annual EVV Policy Training Webinars for Program Providers and FMSAs
- 08/23/2022 Correction to EVV Usage Reports
- 08/16/2022 EVV Policy Handbook Revisions - September 2022
- 08/09/2022 EVV Direction for FMSAs on CDS Employer Usage July 28, 2022
- 08/03/2022 July 2022 EVV Portal and Training Updates July 14, 2022
- 06/10/2022 June 2022 Revised EVV Visit Transaction Rejection Guide
- 06/09/2022 Vesta Windows Ends August 31, 2022
- 05/19/2022 90 Day Notice Before EVV Usage Reviews Begin for CDS Employers
- 05/19/2022 EVV Policy Handbook Revisions - June 2022
- 05/02/2022 EVV Portal and Training Updates
- 05/02/2022 EVV Visit Maintenance Unlock Request Updates
- 04/25/2022 Using an EVV System
- 04/22/2022 HHSC to Request Extension of EVV Cures Act
- 04/13/2022 EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission
- 03/14/2022 EVV Required Free Text Reviews Postponed for CDS Option
- 02/15/2022 EVV Training Updates
- 02/15/2022 EVV 2022 Survey Now Available
- 02/03/2022 EVV Policy Handbook Revisions - March 1, 2022
- 01/18/2022 Guidance for FMSAs when CDS Employers Do Not Perform EVV Responsibilities
- 01/14/2022 Optional EVV Compliance Webinar for Program Providers
- 01/14/2022 EVV Portal and Training Updates
- 01/14/2022 BCBSTX 2022 EVV Training Schedule
- 11/22/2021 EVV Policy Handbook Revisions – January 2022
- 11/04/2021 Revised EVV Policy Handbook Now Available
- 11/04/2021 EVV Service Bill code Table Version 9.6 (STAR Health Updates) Publishing Nov.1
- 11/04/2021 HHSC Publishes the Importance of Following EVV Rules and Policy Guidance for CDS Employers (IL2021-49)
- 10/29/2021 Reminder: Now Available EVV Provider Satisfaction Survey
- 10/01/2021 CDS Employer EVV Usage Compliance Review Grace Period Extended
- 10/01/2021 90-Day Notice of EVV Compliance for Cures Act Personal Care Services Providers
- 10/01/2021 Misuse of EVV Reason Codes Requirements Removed
- 09/02/2021 90 - Day Notice of EVV Compliance for State-Required Personal Care Service Providers
- 09/02/2021 Provider Notice of EVV Claims Review
- 07/26/2021 Home Health Care Services Required to Use EVV by Jan. 1, 2023
-
EVV Archives
-
2021
- 07/16/2021 EVV CDS Webpage Updates low Available
- 07/16/2021 EVV Portal and Training Updates for July 2021
- 05/25/2021 FCC Offers Emergency Broadband Benefit with New Program
- 06/25/2021 Updates to HHSC EVV Mailboxes and Webpage
- 06/30/2021 EVV Visit Maintenance Policy Now Available
- 06/18/2021 August EVV Policy Trainings for FMSAs and CDS Employers
- 06/18/2021 Revised EVV Visit Transaction Rejection Guide Now Available
- 05/14/2021 Annual EVV Policy Trainings for Program Providers
- 05/14/2021 June 29 Quarterly FMSA Webinar
- 05/14/2021 EVV Portal Improvements and Updates for May 2021
- 03/17/2021 EVV Policy Training for CDS Employers Now Available in Spanish
- 02/24/2021 EVV Portal and Training Updates for February 2021
- 02/05/2021 EVV Policy Update: 180 Day & 90 Day Visit Maintenance Temporary Policy
- 01/22/2021 Update: EVV Compliance Oversight Reviews Delayed for EVV Usage and Misuse of EVV Reason Codes
- 01/25/2021 New EVV TAC Rules
- 01/11/2021 Cures Act EVV - Guidance to Ensure On-Time Payment to CDS Employees for Services Done on and After Jan. 1
- 12/30/2020 Provider Notification - 90 Day Visit Maintenance Temporary Policy
- 11/18/2020 Clarification of Electronic Visit Verification (EVV) Requirements – Information Letter 20-47
- EVV Visit Maintenance Policy
- Data Collection Policy
- EVV System Selection Policy
- EVV System Transfer Policy
- EVV Usage Policy
- Schedules Policy
- Service Authorization Policy
- Temporary EVV Policies for COVID-19
- Training Policy
- Temporary EVV Policies for Severe Winter Weather
- 180 Day & 90 Day Visit Maintenance Temporary Policy
- Reason Codes Policy
- Reports Policy
- Electronic Verification Methods Policy
- Claims Matching Policy
- Claims Submission Policy
- EVV Proprietary Systems Policy
- Compliance Oversight Reviews Policy
- EVV Portal Improvements and Training Updates for January 2021
- Module Seventeen: EVV Vendor Transfer Policy and Process
- Module Sixteen: Cures Act EVV Expansion – EVV Vendor Selection and Onboarding
- Module Fifteen: Best Practices to Avoid EVV Claim Mismatches
- Module Fourteen: EVV Compliance Oversight Policies
- Module Thirteen: EVV Training Requirements
- Module Twelve: Getting Started – Next Steps
- Module Eleven: Summary of EVV Changes - Part 1
- Module Ten: EVV Visit Transaction Validation Enhancements
- Module Nine: EVV Portal Standard Reports
- Live Q&A Webinar: EVV Data Aggregator
- Module Eight: Submitting an EVV Claim
- Module Seven: EVV Aggregator
- Live Q&A Webinar: EVV Visit Maintenance and Visit Transactions
- Module Six: EVV Process Flow
- Module Five: EVV Visit Maintenance
- Module Four: EVV Visit Transactions
- Module Three: EVV Roles and Responsibilities (Part 2 of 2)
- Module Two: EVV Roles and Responsibilities (Part 1 of 2)
- Module One: An Introduction to EVV
- Visit Maintenance: Last Visit Maintenance Date Policy
- Visit Maintenance Unlock Request Policy
- EVV 90 Day Visit Maintenance Temporary Policy
- Existing EVV Users: Best Practices for Temporary EVV Policies for COVID-19
- EVV Revised Policies Effective Oct. 1
- New and Revised EVV Policies Effective August 1, 2020
- Temporary EVV Policies for COVID-19 Extended to Oct. 23, 2020
- Existing EVV Users: Temporary Policies for COVID-19 Extended to Oct. 23, 2020
- Temporary EVV Policies for Novel Coronavirus (COVID-19)
- HHSC EVV Vendor Transfer Policy
- HHSC EVV Last Visit Maintenance Date Policy
- HHSC EVV Vendor Selection for Cures Act EVV Expansion Temporary Policy
- EVV Allowable Phone Identification Policy Eff. Sept. 1, 2019
- EVV Billing Policy Eff. Sept. 1, 2019
- EVV Claims Matching Policy Eff. Sept. 1, 2019
- EVV Claims Submission Policy Eff. Sept. 1, 2019
- EVV Data Elements Policy Eff. Sept. 1, 2019
- EVV Reason Code and Required Free Text Policy Eff. Sept. 1, 2019
- EVV Standard Reports Policy Eff. Sept. 1, 2019
- EVV Training Policy Eff. Sept. 1, 2019
- EVV Usage Policy Eff. Sept. 1, 2019
- EVV Vendor Selection Policy Eff. Sept. 1, 2019
- EVV Vendor Transfer Policy Eff. Sept. 1, 2019
- EVV Mobile Application Policy Eff. 04.01.19
-
2020
- EVV Portal Improvements and Training Updates Available
- Updated EVV Service Bill Codes Table and Cures Act EVV Practice Period
- Cures Act EVV: Updated Timeline for Cures Act EVV Expansion
- Cures Act EVV – The EVV Practice Period Begins July 1
- New Approval Process for EVV Proprietary Systems
- Provider Notification – Cures Act EVV Webinars
- Provider Notification – Existing EVV Webinars
- EVV Portal Improvements Now Available
- Provider Notice - Cures Act EVV: New May 1 Deadline to Select an EVV System and Begin the Onboarding Process
- Provider Notice – Temporary EVV Policies in Response to COVID-19
- EVV Training Sessions March 12-13 in Austin for Current Program Providers
- Cures Act EVV Training Sessions March 23-26 in Austin
- Guidance Related to DataLogic/Vesta EVV System Outage in December 2020
- EVV Policy Updates Effective Dec. 1
- Existing EVV Users: Temporary Policies for COVID-19 to end Dec. 31
- EVV Policy Training for CDS Employers on Dec. 11
- Cures Act EVV Practice Period Extended Through Dec. 31
- EVV Proprietary System Update
- EVV Portal and Training Updates
- EVV Policy Update Effective Nov.
- Updated EVV Service Bill Codes Table Effective Oct. 1
- Cures Act EVV: Practice Period Update and Important Dates
- EVV Visit Transaction Rejection Errors Guide Now Available
- EVV Portal and TexMedConnect Improvements and Training Updates Available
- Information Letter (IL) 20-33: EVV Guidance for FMSAs and CDS Employers
- Cures Act EVV Prepare to Submit CDS and SRO Managed Care EVV Claims to TMHP
-
2019
- EVV Proprietary Systems – New Proprietary System Onboarding Process Information Available
- EVV Portal – Updates to EVV Portal Standard Reports and TexMedConnect
- Announcement of EVV Vendors
- EVV Visit Maintenance Extension Reminder
- EVV Visit Maintenance Timeframe Extended for Visits with Dates of Service Sept. 1, 2019 – Oct. 31, 2019
- CMS has Approved HHSC’s Request to Delay the EVV Start Date
- HHSC Requests Cures Act Extension
- EVV Training Begins Aug. 1, 2019
- EVV Roadshow ILT Schedule Summer/Fall 2019
- TMHP Upcoming Webinars for EVV
- EVV Visit Maintenance Unlock Request Policy Eff. 07.01.2019.pdf
- EVV Billing Requirements Eff. 09.01.2019
- EVV Contact Information Matrix
- EVV Visit Transaction Validation Enhancements Eff. 06.01.19
- Changes to EVV Vendor System Eff. 06.01.19
- EVV Mobile Application Available 04.01.19
- EVV Provider Data Validation Process
- Reminder EVV Visit Maintenance of MEDsys Historical Data
- EVV Updated Billing Policy Requirements
- EVV Visit Maintenance of MEDsys EVV Historical Data
- EVV Data Access Request Form
- 21st Century Cures Act: Texas EVV Implementation
- EVV Tool Kit Alert- Module Five: EVV Visit Maintenance
- EVV Tool Kit Alert- Module Four: EVV Visit Transactions
- EVV Tool Kit Alert – Module Three: EVV Roles and Responsibilities
- EVV Tool Kit Alert – Module Two: EVV Roles and Responsibilities
- EVV Tool Kit Alert - Module One: An Introduction to EVV
- Reminder: April 1 Deadline to Select an EVV System
- Cure's Act EVV Expansion – April 1 Deadline to Select an EVV System
-
2018
- Change to Access of Historical EVV Records Stored by Sandata
- Communication from Unaffiliated Third Party Regarding EVV
- Access to MEDsys Data
- Proprietary EVV System Survey for Providers
- Potential Evaluation of EVV Vendor Pool
- Final Reminder to Transition EVV Providers
- Mid October Reminder to EVV Providers Transitioning to Datalogic
- Important Reminder To EVV Providers Transitioning to Datalogic
- Reminder To EVV Providers Transitioning to Datalogic
- 21st Century Cures Act and EVV
- Notice of Billing Policy Changes to Providers Required to Use EVV
- EVV Provider Transitioning to Datalogic
- Transitioning Providers: EVV Claims May Be Denied Or Recouped
- EVV Revises Unallowable Phone Identification and Recoupment Policy
- Transitioning Provider FAQs and Reminders
- EVV Electronic Authorization Pilot
- IMPORTANT Revision to MEDsys-Issued SAD Return Policy
- Visit Maintenance Reduction Solutions
- Updated- Temporary Reduction to EVV Compliance
- MEDsys Providers Must Initiate Transition to DataLogic by July 31, 2018
- Data Collection Information for Providers Transitioning to Datalogic Vesta EVV System
- Toll Free Numbers and SADs
- SAD Zip Tie Policy Change
- Temporary Reduction to EVV Compliance
- Provider Transition Solutions and Benefits
- Order Small Alternative Devices Electronically Beginning May 1, 2018
- EVV Alert Tour of Texas Sessions
- EVV Alert Transition Timeline
- HHSC's MEDsys Contract Expires - Will Not Be Renewed
- EVV Cell Phone Policy
- EVV FAQ
- October 2017 HHSC EVV Reason Code Scenarios
- HHSC EVV Reason Code Scenarios Answer Key
- Provider Stakeholder Meeting
- Health and Human Services EVV Information
- Health and Human Services EVV FAQ
- Provider Stakeholder Meeting
- Health and Human Services EVV Information
- Health and Human Services EVV FAQ
- EVV Reason Codes
- BCBSTX Provider Compliance Plan
- BCBSTX STAR Kids EVV FAQ
- Important Reminders on Cell Phone Use with EVV
- Small Alternative Devices Must be Installed in the Home
- 2017
-
2021
2023 Electronic Visit Verification (EVV) Provider Webinar Sessions
Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid hosts 30-minute webinar sessions to learn more about Electronic Visits Verifications (EVV) system and process. Registration is required for webinar, refer to our Provider Training Webinar page.
Important Contact Information
Blue Cross and Blue Shield of Texas (BCBSTX) Contact Information:
- For EVV questions, call Provider Customer Service at 1-877-784-6802 or email the EVV Mailbox at BCBSTX_EVV_Questions@bcbstx.com
- For Service Coordination needs, call 1-877-301-4394 (TTY 7-1-1)
- Information on how to submit a Complaint or Appeal
For EVV Visit Maintenance Unlock Request (VMUR) :
- Instructions and Templates -Complete either form
- VMUR Job Aids
Health and Human Services EVV Contact Information:
- EVV Email: EVV@hhs.texas.gov
- EVV Website: Electronic Visit Verification | Texas Health and Human Services
TMHP EVV Contact Information:
- EVV Email: EVV@tmhp.com
- EVV Website: Electronic Visit Verification (EVV) | TMHP
- EVV TMHP Proprietary System Website: EVV Proprietary Systems | TMHP
- EVV TMHP Vendor Website: EVV Vendors |TMHP
Vendor Contact Information:
| DataLogic Software, Inc. / Vesta | First Data Government Solutions / AuthentiCare |
|---|---|
Phone: 1-844-880-2400 |
Phone: 1-877-829-2002 |
- CDS Employer EVV Contact Information Guide
- Cures Act Home Health Care Services required to use EVV
- EVV Service Bill Codes Table
- Personal Care Services required to use EVV
- Program and Service Requirements for Schedules
- Program Provider and FMSA EVV Contact Information Guide
- Proprietary System Operator Onboarding Process
EVV Compliance Oversight Reviews Section
EVV Compliance Oversight Review is currently under revision. Review Section 10000 EVV Compliance Reviews from the EVV Policy Handbook for more information.
State Fiscal Year (SFY) 2023
Usage Score Compliance - State Fiscal Year 2023
Provider Type |
Quarter 1 (Q1) |
Quarter 2 (Q2) |
Quarter 3 (Q3 |
Quarter 4 (Q4) |
Agency Providers - In Compliance |
10 |
9 |
|
|
Agency Providers – Not in Compliance |
5 |
5 |
|
|
FMSAs - In Compliance |
8 |
7 |
|
|
FMSAs – Not in Compliance |
0 |
0 |
|
|
Free Text Compliance - State Fiscal Year 2023
Date
|
Agency Providers - In Compliance |
Agency Providers – Not in Compliance |
FMSAs - In Compliance |
FMSAs – Not in Compliance |
September 2022 |
5 |
10 |
3 |
5 |
October 2022 |
11 |
4 |
4 |
4 |
November 2022 |
10 |
4 |
4 |
4 |
December 2022 |
9 |
4 |
3 |
4 |
January 2023 |
9 |
5 |
2 |
5 |
February 2023 |
8 |
6 |
2 |
5 |
March 2023 |
7 |
7 |
2 |
5 |
April 2023 |
9 |
4 |
2 |
6 |
Landline Phone Compliance - State Fiscal Year 2023
Date
|
Agency Providers - In Compliance |
Agency Providers – Not in Compliance |
FMSAs - In Compliance |
FMSAs – Not in Compliance |
|
September 2022 |
12 |
3 |
7 |
1 |
|
October 2022 |
13 |
2 |
9 |
0 |
|
November 2022 |
11 |
3 |
8 |
0 |
|
December 2022 |
12 |
2 |
7 |
0 |
|
January 2023 |
11 |
3 |
7 |
0 |
|
February 2023 |
13 |
1 |
7 |
0 |
|
March 2023 |
12 |
2 |
7 |
0 |
|
April 2023 |
13 |
1 | 7 | 0 | |
May 2023 |
14 |
0 |
7 |
0 |
|
June 2023 |
13 |
1 |
7 |
0 |
|
July 2023 |
13 |
1 |
7 |
0 |
Most Common Reasons for Denial
State Fiscal Year 2023 - EVV Relevant Claims
State Fiscal Year 2023 |
Most Common Reasons |
Quarter 1 |
1. EVV06 - Units Mismatch 2. Timely Filing 3. Duplicate Claims 4. EVV05 - Service Mismatch 5. EVV03 - DOS Mismatch |
Quarter 2 |
1. Service not authorized/Other 2. EVV06 - Units Mismatch 3. EVV05 - Service Mismatch 4. EVV03 - DOS Mismatch 5. Duplicate Claims |
Quarter 3 |
1. Duplicate Claims 2. EVV05 - Service Mismatch 3. Service Not Authorized/Other 4. Attestation 5. EVV06 - Units Mismatch |
Most Common Reasons for Recoupment
Each quarter, this section is updated with the top reasons of recoupment for EVV-relevant claims.
BCBSTX has not had any recoupments of EVV - relevant claims in State Fiscal Year 2023.
Span Billing Guidelines
BCBSTX allows for EVV claims to be submitted with a span date. If a provider chooses to submit a claim with a span date, the provider must ensure that:
- Each date within the span has one or more matching EVV visit transactions.
- The total units on the EVV claim must match the combined total units of the matched EVV visit transactions.