Section 12006 of the 21st Century Cures Act (the Cures Act) requires that the North Carolina Department of Health and Human Services (NCDHHS) begins using an Electronic Visit Verification (EVV) system for Home Health Care Services (HHS) by Jan. 1, 2023.
In compliance with the Cures Act, NC Medicaid has determined that the following services covered through the State Plan and the 3-A Home Health Clinical Coverage Policy will be subject to the EVV requirement:
- Aide Services
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Skilled Nursing Visits
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
HHS claims with the revenue codes below are subject to this change:
|
Revenue Code |
|
|
|
THERAPIES |
|
420 |
Physical therapy |
|
424 |
Physical therapy evaluation |
|
430 |
Occupational therapy |
|
434 |
Occupational therapy evaluation |
|
440 |
Speech-language pathology services |
|
444 |
Speech-language pathology services evaluation |
|
|
SKILLED NURSING VISITS |
|
550 |
Skilled nursing: Initial assessment/re-assessment (Initial assessment of a new patient or 60-calendar-day re-assessment) |
|
551 |
Skilled nursing: Treatment, teaching/training, observation/evaluation |
|
559 |
Skilled nursing: For a dually eligible beneficiary when the visit does not meet Medicare criteria (for example, the beneficiary is not homebound) |
|
580 |
Skilled nursing: venipuncture |
|
581 |
Skilled nursing: Pre-filling insulin syringes/Medi-Planners |
|
|
HOME HEALTH AIDE |
|
570 |
Home Health Aide |
Jan. 1, 2023, marks the go-live date for EVV for HHS. A soft launch is planned for October 2022 (date to be determined).
NC Medicaid has an established EVV webpage with more information. Home Health providers are encouraged to monitor this webpage frequently for HHS EVV announcements, bulletins, FAQs, stakeholder meetings and other communications.
The next EVV Stakeholder Meeting for HHS is planned for April 25, 2022, from 10 - 11:30 a.m. Stakeholders will receive an email with registration information.
CONTACT
NC Medicaid Clinical Section
Phone: 919-855-4380
Fax: 919-715-9025