About Electronic Visit Verification (EVV)
In December 2016, Congress enacted the 21st Century Cures Act which requires states to implement Electronic Visit Verification (EVV) for Medicaid-financed Personal Care Services and Home Health Care Services by January 1, 2020 and January 1, 2023, respectively, to avoid a reduction in federal Medicaid funding. The Act contributes to Georgia Medicaid’s mission of providing access to affordable, quality health care services for Medicaid members.
EVV is a technology that automates the gathering of service information by capturing time, attendance and care plan information entered by a home care worker at the point of care. EVV gives providers, care coordinators, and DCH access to service delivery information in real-time to ensure there are no gaps in care throughout the entire course of the service plan. The technology helps to reduce the occurrence of fraud in-home care delivery by removing the elements most closely associated with improper record keeping including paper timesheets and manual billing.
At a minimum, EVV electronically verifies the:
- Type of service performed
- Individual receiving the service
- Individual providing the service
- Date the service was provided
- Location of service delivery
- Time the service begins and ends
- Individual providing the service
- Individual receiving the service
Medicaid-funded Personal Support Services (PSS)/Community Living Supports (CLS) (CPT Codes T1019, T2025, and S9122) for the following waiver programs will be subject to EVV Program requirements:
- Elderly and Disabled Waiver (CCSP and SOURCE) 590 and 930
- Independent Care Waiver Program (ICWP) 660
- New Option Waiver (NOW) & Comprehensive Services and Supports (COMP) 680 & 681:
- Community Living Supports
- Community Living Support Services - Self-Directed
- Community Living Support Services - Co-Employer
- Georgia Pediatric Program (GAPP) 971
- Community Living Supports
- New Option Waiver (NOW) & Comprehensive Services and Supports (COMP) 680 & 681:
- Independent Care Waiver Program (ICWP) 660
*See Claims section for specific Electronic Visit Verification (EVV) Home and Community-Based Services (HCBS) Applicable Codes.
Home Health Care Services (HHCS): COS 200; Specialty 088 – Home Health Agency Please Note: Prior Authorizations are not required for HHCS services. Physician Orders are required.
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