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HHSC will require Electronic Visit Verification (EVV) for Medicaid home health care services (HHCS) beginning Jan. 1, 2024, as listed in the Home Health Care Services required to use EVV (PDF). The 21st Century Cures Act is the federal law that requires states to implement EVV.
HHCS Claims for EVV Required Services Must be Submitted to TMHP Starting Dec. 1
- Program providers and financial management services agencies (FMSAs)?must?submit all HHCS EVV claims to Texas Medicaid & Healthcare Partnership (TMHP) using TexMedConnect, or through Electronic Data Interchange (EDI) using a Compass 21 (C21) Submitter ID starting with dates of service on or after Dec. 1, 2023.
- Managed care organizations (MCOs) will reject any HHCS managed care claims with EVV services and dates of service on or after Dec. 1, 2023, back to the program provider and FMSA, directing them to submit the claim to TMHP for EVV claims matching.
Register for TexMedConnect
- To access TexMedConnect through the TMHP website you must already have an account. If you don?t have an account, set one up using the information provided in the TMHP Website Security Provider Training Manual.
- Program providers and FMSAs that need help setting up C21 or CMS Submitter IDs should contact the EDI Help Desk at 888-863-3638, Option 4, or visit the TexMedConnect webpage for additional information.
Request EVV Portal Access
Complete Onboarding and EVV Portal Training by December 31
Program providers and FMSAs must complete the following before December 31 to avoid impacts to EVV claims payment:
- Onboard with the state-funded EVV vendor system, HHAeXchange by submitting the HHAeXchange Provider Onboarding Form.
- Complete the TMHP Learning Management System (LMS) to complete annual EVV Portal training requirements.
Visit the?TMHP EVV Training webpage?for more information.
EVV Home Health Care Services Practice Period: Oct. 1-Dec. 31, 2023
The practice period allows program providers and FMSAs, to practice using the EVV system, using the EVV Portal and submitting EVV claims before the Jan. 1, 2024, implementation date. EVV claims will be paid by the payers (HHSC or MCO) even if the EVV visit transactions do not match the EVV claims.
- Consumer Directed Services (CDS) employers can practice using the EVV system selected by their FMSA.
- Service providers and CDS employees can practice clocking in and clocking out using their program provider?s or FMSA?s selected EVV system, and the visit data will be transmitted to the EVV Aggregator.
EVV Claims Matching with Denials
Effective Jan. 1, 2024, and after, when an HHCS EVV claim is submitted without a matching EVV visit transaction, the EVV claim will be denied. This applies to all program providers and FMSAs required to use an EVV system. Program providers and FMSAs will be able to view EVV claim match results in the EVV Portal.
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