Electronic Visit Verification
Electronic visit verification (EVV) is a computer-based system that electronically documents and verifies service delivery information for certain Medicaid service visits. EVV helps prevent fraud, waste and abuse, while making sure Medicaid recipients receive care that is authorized for them.
Parkland Community Health Plan complies with all of HHSC’s EVV policies and procedures.
Why is EVV required?
The 21st Century Cures Act (Section 12006), or Cures Act, is a federal law passed in 2016 requiring states to implement EVV for Medicaid personal care services (PCS) and home health care services (HHCS) that require an in-home visit. States that do not implement EVV will receive reduced federal Medicaid funding.
Programs and Services required to use EVV:
Programs and services required to use EVV are defined in HHSC Texas Administrative Code Section 354.4005, Applicability.
A summary of the personal care services required to use EVV is available on the HHSC EVV webpage.
3100 EVV Service Bill Codes
The EVV Service Bill Codes Table provides current billing codes for EVV-relevant services in long-term care, acute care and managed care programs.
Program providers and FMSAs must use the appropriate Healthcare Common Procedure Coding System (HCPCS) and modifier combinations in the EVV Services Bill Codes table to prevent EVV visit transaction rejections and EVV claim match denials.
EVV Policies & Procedures
- HHSC EVV Provider Policy Handbook
- EVV Compliance
- EVV Quarterly Provider Compliance Review
- PCHP Claims and Billing
- PCHP Complaints and Appeals
- PCHP Provider Portal Login
- PCHP Provider Manual
EVV Training & Education
- HHSC Next Steps and Timeline for Transition to HHAeXchange
- HHSC EVV Vendor Information Center- HHAeXchange
- HHSC EVV Policy Training
- HHSC EVV Policy Self-Paced Training
- HHSC EVV Implementation FAQs (PDF)
- Initial EVV Policy Training Webinar for Program Providers and FMSAs
- HHSC EVV Training Page
- HHSC EVV Training Resources
- HHSC EVV Training Requirements Checklists (PDF)
- HHSC 21st Century Cures Act
- HHSC Programs, Services and Service Delivery Options Required to Use EVV
- TMHP EVV Portal Training
- PCHP Policy Training
EVV 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.
PCHP follows the HHSC EVV Maintenance Unlock Request process:
EVV Alerts
This section provides EVV alerts on changes or updated information specific to Parkland Community Health Plan and HHSC.
- EVV Alternative Device Phase-Out Schedule for Public Comment – Due by May 15
- Updates to the EVV Visit Maintenance Processes Hold for HHAeXchange System Users for Dates of Service Prior to Go-Live Date
- Programs, Services and Service Delivery Options Required to Use EVV
- Billing Electronic Visit Verification (EVV) Services as Secondary Insurance Claim
- New EVV Visit Transaction Rejection Codes Effective April 1, 2024
- EVV Claims Matching Resumes April 1, 2024; Unmatched EVV Claims will Deny for Payment
- Updates to HHAeXchange Training Resources for EVV Program Providers and FMSAs
- Register for the EVV HHAeXchange Forum Webinar
- TMHP Register for the Texas EVV HHAeXchange Town Hall Webinars
- HHSC Qualifications and Ordering an EVV Alternative Device Policy
- HHSC EVV Policy Updates Now Available for Alternative Devices
- HHSC EVV Take Action Now - Onboard with HHAeXchange
- HHSC EVV Systems AuthentiCare and Vesta Available for Use Through Set. 30, 2023
- HHSC EVV Complete Visit Maintenance Before Dec.22
- HHSC EVV Policy Updates Now Available for Alternative Devices
- HHSC EVV Take Action Now: Onboard with HHAeXchange
