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Electronic Visit Verification - Now Required for Certain Services

By July 1, 2021, Providers need to have in place Electronic Visit Verification (EVV) for all of the below eight (8) listed services when they are delivered in the home..  If the service is delivered by a live in caregiver, in the community or in a congregate setting (ie group home/supervised apartment), the requirement for EVV is exempt and the Provider will instead submit their claims directly to Gainwell (Medicaid) as they have been doing.


Providers DDD approved for these eight services must become "Operational" EVV providers by October 31 to be able to continue serving consumers. Currently, providers needing EVV qualification are in one of three statuses, Disengaged, Provisionally Engaged, or Operational. Disengaged providers can not accept new consumers as of August 1. Provisionally Engaged providers cannot accept new consumers as of September 1 while Operational providers can continue to provide their services to their consumers.    

  

In all circumstances when any of these 8 services are listed in the ISP, the Support Coordinator must indicate in the service description box whether EVV is applicable or whether it is exempt.  (Examples: This service will require EVV.  This service is exempt from EVV.)  This should begin immediately for all anniversary plans, and as you complete any needed revisions for existing plans.  Please note that the July 1st deadline does not pertain to the plans, but only to the implementation of EVV.  Please let me know if you have any questions, or concerns.  

  

Services requiring EVV Statements

Unit of Service

Procedure Code

DDD Individual Supports (Base Rate)

15 minutes

H2016HI

DDD Individual Supports (With Acuity Rate)

15 minutes

H2016HI22

DDD Individual Supports

(Reasonable and Customary/Self-Directed Employee)

15 minutes

H2016HIU8

DDD In Home Respite (Base Rate)

15 minutes

T1005HI

DDD In Home Respite

(Reasonable and Customary/Self-Directed Employee)

15 minutes

T1005HIU8

DDD Community Based Supports (Base Rate)

15 minutes

H2021HI

DDD Community Based Supports (With Acuity Rate)

15 minutes

H2021HI22

DDD Community Based Supports

(Reasonable and Customary/Self-Directed Employee)

15 minutes

H2021HI52

 

 

 

  

Support Coordination Responsibilities

  Assist Families in understanding the EVV federal mandate.

  Inform Families how EVV will affect their services. 

  Communicate challenges families experience to the provider agency and/or DDD and HHAeXchange. 

  Document EVV Applicable, and EVV exempt, Services in iRecord. 


Any questions, regarding your providers EVV status contact your Support Coordinator.

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