The migration of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) forms and claims entry to Texas Medicaid & Healthcare Partnership (TMHP) has been moved from March 1, 2022, to May 1, 2022. The postponement allows more time for program providers and financial management services agencies (FMSAs) to set up the necessary TMHP accounts and take relevant training courses. HCS and TxHmL program providers and FMSAs must continue to use the Client Assignment and Registration (CARE) system to submit claims using existing billing code combinations for service groups 12 and 15 for dates of service prior to May 1, 2022.
HHSC is aware that some program providers and FMSAs updated authorizations in the EVV systems to reflect the new billing code combinations for service groups 21 and 22 that were scheduled to take effect March 1, 2022. To avoid the re-entry of authorizations, HHSC and TMHP will take the following actions:
- By March 4, 2022, the EVV Aggregator will accept billing code combinations for service groups 12, 15, 21 and 22 on EVV visits for dates of service through April 30, 2022, to prevent visit rejections.
- For dates of service on or after May 1, 2022, the EVV Aggregator will only accept billing code combinations for service groups 21 and 22.
- Turn on the EVV07 claims matching bypass for all HCS and TxHmL billing code combinations to avoid claim denials through May 31, 2022.
- Claims matching for all HCS and TxHmL billing code combinations will resume June 1, 2022.
- Publish an updated EVV Service Bill Codes Table to reflect these changes.
Program Providers, FMSAs, and CDS employers must continue to use EVV during this period; however, HCS and TxHmL claims will not be denied for an EVV mismatch. HCS and TxHmL claims during this period are still subject to HHSC provider fiscal compliance reviews conducted by HHSC Provider Fiscal Compliance.
For visits that have been rejected by the aggregator due to incorrect billing code combinations, program providers and FMSAs must re-export the visit and ensure it is accepted in the EVV aggregator prior to submitting claims.
Please refer to HHSC’s ‘Continue Submitting Claims and Forms Using CARE System Until May 1, 2022’ notice for more information.