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.
ServiceCodeModifierUnits 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 Therapy  15 min
Physical Therapy 5915 min
Occupational Therapy  15 min
Occupational Therapy 5915 min
Home Health Aide  1 hour
Skilled Nursing  1 hour
Skilled Nursing  1 hour