Georgia 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

Electronic Visit Verification (EVV) Applicable Codes

Elderly and Disabled Waiver (CCSP and SOURCE) 590 and 930
ServiceCodeModifier 1Modifier 2Modifier 3 Modifier 4
Personal Support ServicesT1019    
Extended Personal SupportT1019TF   
Consumer Direct PSST1019UC   
Independent Care Waiver Program (ICWP) 660
ServiceCodeModifier 1 Modifier 2Modifier 3Modifier 4
Personal Support Level IT2025U5TF  
Personal Support Level IIT2025U5TG  
Personal Support Consumer Directed T2025U5UC  
TBI Personal Support IT2025U5U1TF 
TBI Personal Support Level IIT2025U5U1TG 
New Option Waiver (NOW) & Comprehensive Services and Supports (COMP) 680 & 681
ServiceCodeModifier 1Modifier 2Modifier 3Modifier 4
Community Living Support Services     
CLS – 1 MemberT2025U4   
CLS – 1 MemberT2025U5   
CLS – 2 MemberT2025U4UN  
CLS – 2 MemberT2025U5UN  
CLS – 3 MemberT2025U4UP  
CLS – 3 MemberT2025U5UP  
Community Living Support Services – Self-Directed     
CLS – 1 Member – Self - DirectedT2025U4UC  
CLS – 1 Member – Self - DirectedT2025U5UC  
CLS – 2 Member – Self - DirectedT2025U4UNUC 
CLS – 2 Member – Self - DirectedT2025U5UNUC 
CLS – 3 Member – Self - DirectedT2025U4UPUC 
CLS – 3 Member – Self - DirectedT2025U5UPUC 
Community Living Support Services – Co-Employer     
CLS – 1 Member – Self - DirectedT2025U4UA  
CLS – 1 Member – Self - DirectedT2025U5UA  
CLS – 2 Member – Self - DirectedT2025U4UNUA 
CLS – 2 Member – Self - DirectedT2025U5UNUA 
CLS – 3 Member – Self - DirectedT2025U4UPUA 
CLS – 3 Member – Self - DirectedT2025U5UPUA 
Georgia Pediatric Program (GAPP) 971
ServiceCodeModifier 1Modifier 2Modifier 3Modifier 4
Personal Care SupportS9122    
Personal Care Support using the Family Caregiver OptionS9122U2   
Home Health Care Services (HHCS): COS 200; Specialty 088 – Home Health Agency. Please Note: Physician Orders are required. Refer to applicable part two policy manuals for PA requirements  *Note: The HHCS EVV codes are listed for reference only. These codes are not yet required to be EVV compliant, as HHCS implementation is still in progress.
ServiceCodeModifier 1Modifier 2Modifier 3Modifier 4Units Billed
Speech Therapy92507    1 unit per day
Physical Therapy97161    1 unit per day
Physical Therapy97162    1 unit per day
Physical Therapy97163    1 unit per day
Physical Therapy97164    1 unit per day
Occupational Therapy97165    1 unit per day
Occupational Therapy97166    1 unit per day
Occupational Therapy97167    1 unit per day
Occupational Therapy97168    1 unit per day
Physical TherapyG0151    15 min
Physical TherapyG015159   15 min
Occupational TherapyG0152    15 min
Occupational TherapyG015259   15 min
Home Health AideS9122    1 hour
Skilled NursingS9123    1 hour
Skilled NursingS9124    1 hour