Span Dating Ends Jan. 1, 2021 for Providers Subject to Electronic Visit Verification

Tuesday, December 1, 2020

Effective Jan. 1, 2021, Personal Care Services (PCS) and Community Alternatives Programs (CAP/C and CAP/DA) providers subject to Electronic Visit Verification (EVV) will no longer be able to submit claims using span dating. 

To comply with the EVV requirements, each in-home visit must receive a validation of the core components of EVV. To ensure that each claim line complies with the EVV requirements, the “From (date of service)” and “To (date of service)” field on each claim line must be the same or the claim line will deny.  

Because each date of service billed must be validated to ensure that an EVV record is on file for that specific date of service, it is necessary to bill each date of service as a separate claim detail line.

EVV is required by Section 120006 of the 21st Century Cures Act as a method used to verify visit activity for services delivered as part of home- and community-based service programs. 

EVV will verify:

  • Date of service
  • Beneficiary receiving services 
  • Location of service
  • Person providing service
  • Type of service rendered
  • Time the service begins and ends

Personal Care claims with the combination of Procedure/Modifier code listed below are subject to this change:
[NOTE: "##" indicates "blank" as there is no modifier for that service.]

Procedure Code

Modifier

99509         

HA

99509         

HB

S5125         

##

S5125         

##

S5125         

UN

S5125         

##

S5125         

UN

S5135         

##

S5135         

UN

S5150         

##

S5150         

##

S5150         

##

S9122         

TF

S9122         

TG

S9122         

TF

S9122         

TG

T1004         

##

T1019         

##

T2027         

##

Contact

NCTracks Contact Center: 800-688-6696