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Cures Act EVV: CDS and SRO Managed Care EVV Claims Must be Submitted to TMHP

Last updated on 10/1/2020

Effective October 1, 2020, all managed care claims for Electronic Visit Verification (EVV)-relevant services that are delivered through the Consumer Directed Services (CDS) option or Service Responsibility Option (SRO) must be submitted to TMHP for the EVV claims matching process to occur.

EVV claims that have a date of service on or after October 1, 2020, and are submitted directly to a managed care organization (MCO) will now be denied or rejected.

Get Set Up to Submit Claims

Program providers and financial management services agencies (FMSAs) who haven’t already set themselves up to submit claims to TMHP can refer to How to Setup Managed Care EVV Claims Submission to TMHP guide for instructions.

Important: EVV claims cannot be submitted to TMHP until the claims submission setup process is complete, which can take up to three weeks.

TMHP has also identified program providers and FMSAs who need to complete the setup process and will continue to perform outreach by phone to offer assistance.

Program providers and FMSAs who need help getting set up can also call the TMHP EDI Help Desk directly at 1-888-863-3638, Option 4, or email evv@tmhp.com.

Previous Communications

TMHP and the Texas Health and Human Services Commission (HHSC) notified program providers and FMSAs that they were required to setup managed care EVV claims submission by the October 1, 2020, deadline in the following communications:

Additional Resources

Program providers and FMSAs can also visit the:

HHSC Cures Act EVV Webpage for information about the practice period, including the claims matching process.

HHSC GovDelivery site to sign up for EVV updates by email.

For more information, contact evv@tmhp.com.