NC Medicaid will implement Electronic Visit Verification (EVV) for Home Health Care Services (HHCS) as required by the 21st Century Cures Act on April 1, 2023, for HHCS delivered under the Standard Plans and NC Medicaid Direct. The implementation date of HHCS delivered under the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans will occur on a later date due to the delay of the Tailored Plan launch.
To ensure full compliance with this mandate and to compensate for the administrative oversight of capturing the six required EVV data points for HHCS subject to EVV, the rates for HHCS shall be increased by 10% above the current fee schedule rate.
The new rates will be retroactive to Feb. 1, 2023. Impacted providers do not need to make any changes to their previously submitted claims - affected claims will be systematically reprocessed.
The 10% increased unit rate applies to the HHCS noted below.
|
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 |