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
| Service | Code | Modifier 1 | Modifier 2 | Modifier 3 | Modifier 4 |
|---|---|---|---|---|---|
| Personal Support Services | T1019 | ||||
| Extended Personal Support | T1019 | TF | |||
| Consumer Direct PSS | T1019 | UC |
| Service | Code | Modifier 1 | Modifier 2 | Modifier 3 | Modifier 4 |
|---|---|---|---|---|---|
| Personal Support Level I | T2025 | U5 | TF | ||
| Personal Support Level II | T2025 | U5 | TG | ||
| Personal Support Consumer Directed | T2025 | U5 | UC | ||
| TBI Personal Support I | T2025 | U5 | U1 | TF | |
| TBI Personal Support Level II | T2025 | U5 | U1 | TG |
| Service | Code | Modifier 1 | Modifier 2 | Modifier 3 | Modifier 4 |
|---|---|---|---|---|---|
| Community Living Support Services | |||||
| CLS – 1 Member | T2025 | U4 | |||
| CLS – 1 Member | T2025 | U5 | |||
| CLS – 2 Member | T2025 | U4 | UN | ||
| CLS – 2 Member | T2025 | U5 | UN | ||
| CLS – 3 Member | T2025 | U4 | UP | ||
| CLS – 3 Member | T2025 | U5 | UP | ||
| Community Living Support Services – Self-Directed | |||||
| CLS – 1 Member – Self - Directed | T2025 | U4 | UC | ||
| CLS – 1 Member – Self - Directed | T2025 | U5 | UC | ||
| CLS – 2 Member – Self - Directed | T2025 | U4 | UN | UC | |
| CLS – 2 Member – Self - Directed | T2025 | U5 | UN | UC | |
| CLS – 3 Member – Self - Directed | T2025 | U4 | UP | UC | |
| CLS – 3 Member – Self - Directed | T2025 | U5 | UP | UC | |
| Community Living Support Services – Co-Employer | |||||
| CLS – 1 Member – Self - Directed | T2025 | U4 | UA | ||
| CLS – 1 Member – Self - Directed | T2025 | U5 | UA | ||
| CLS – 2 Member – Self - Directed | T2025 | U4 | UN | UA | |
| CLS – 2 Member – Self - Directed | T2025 | U5 | UN | UA | |
| CLS – 3 Member – Self - Directed | T2025 | U4 | UP | UA | |
| CLS – 3 Member – Self - Directed | T2025 | U5 | UP | UA |
| Service | Code | Modifier 1 | Modifier 2 | Modifier 3 | Modifier 4 |
|---|---|---|---|---|---|
| Personal Care Support | S9122 | ||||
| Personal Care Support using the Family Caregiver Option | S9122 | U2 |
| Service | Code | Modifier | Units Billed |
|---|---|---|---|
| Speech Therapy | 92507 | 1 unit per day | |
| Physical Therapy | 97161 | 1 unit per day | |
| Physical Therapy | 97162 | 1 unit per day | |
| Physical Therapy | 97163 | 1 unit per day | |
| Physical Therapy | 97164 | 1 unit per day | |
| Occupational Therapy | 97165 | 1 unit per day | |
| Occupational Therapy | 97166 | 1 unit per day | |
| Occupational Therapy | 97167 | 1 unit per day | |
| Occupational Therapy | 97168 | 1 unit per day | |
| Physical Therapy | 15 min | ||
| Physical Therapy | 59 | 15 min | |
| Occupational Therapy | 15 min | ||
| Occupational Therapy | 59 | 15 min | |
| Home Health Aide | 1 hour | ||
| Skilled Nursing | 1 hour | ||
| Skilled Nursing | 1 hour |