Section 12006 of the Cures Act states the Medicaid Home Health Care Services subject to Electronic Visit Verification (EVV) are:
- 1905(a)(7) State Plan Home Health Services
- Home Health services authorized under a waiver
EVV applies to: therapy services (physical therapy, occupational therapy or speech therapy) delivered by a therapist either by contract or as a direct employee where the Prior Authorization (PA) is issued to the billing Home Health Agency NPI.
EVV does not apply to: Independent Practitioner Providers (IPPs) providing therapy services (physical therapy, occupational therapy, or speech therapy) that may be performed in various settings, including the beneficiary’s home. In this incidence, the Independent Practitioner would have the PA issued to the IPP billing NPI and bills Medicaid directly as an IPP.