NC Medicaid Home Health Electronic Visit Verification: Billing Instructions for NC Medicaid Direct
Update for Providers Using Alternate Electronic Visit Verification: Visit Capture Home and Community Defined

Update for Providers Using Alternate Electronic Visit Verification: Visit Capture Home and Community Defined

Beginning Jan. 1, 2023, Home Health providers will be subject to Electronic Visit verification (EVV) at which time, Home Health services visits must be billed in a way that allows for visit validation on a per visit basis. 

For the EVV record to match the claim, providers billing multiple Home Health services (i.e., physical therapy and a skilled nursing visit) on the same date of service must use one revenue code per claim line. Providers can no longer span dates on a single claim line or bill all units for the entire month.

All providers subject to the EVV requirements must indicate the location of each visit, home, or community in the service location field for a visit to be validated in the Sandata Aggregator.

Home is defined as the beneficiary’s address listed in EVV.

Community is defined as any/all other locations as defined in NC Medicaid Home Health Services 3-A Clinical Coverage Policy:

Home Health services clinical coverage policy, section 1.0 Description of the Procedure, Product, or Service. The address of the beneficiary listed in EVV is not an acceptable community location selection.

Contact

medicaid.evv@dhhs.nc.gov

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