Home health care services: electronic visit verification

Overview

Electronic visit verification (EVV) is a federal requirement of the 21st Century Cures Act, passed by Congress in 2016 requiring that Medicaid funded in-home personal care services, respite care services, and home health care services are verified as having been provided.

Home health care services (HHCS) covers any home health services included in the home health billing instructions and encounter data reporting guide. These will be updated July 1, 2023.

HHCS providers will be required to have an EVV solution in place by January 1, 2024 or risk having their claims denied or encounters rejected under a mandate included in the 21st Century Cures Act.

Current and new required data elements

Beginning January 1, 2024, there will be three new required data elements. All data element requirements include:

• Type of service performed (existing)
• Individual receiving the service (existing)
• Date of service (existing)
• Location of service delivery (new)
• Individual providing the service (new)
• Time the service begins and ends (new)

Provider requirements

Providers will need to:

1. Procure an EVV solution. 
2. Enroll current servicing providers. This is one of the data elements that is required to be submitted on the claim/encounter.
3. Submit the required data elements on all HHCS claims and encounters.

Providers shall procure their EVV solution of choice and must self-fund their EVV implementation. This allows the flexibility to select an option that best meets their business needs and the needs of their clients.

Timeline

• Home health billing instructions and encounter data reporting guide will be updated July 1, 2023.
• ProviderOne will accept the new EVV HHCS data elements July 1, 2023.
• New data elements will be mandatory January 1, 2024.