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In-Home Individualized Skills and Socialization Claims Will Deny without EVV on May 1

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This is a reminder that Electronic Visit Verification (EVV) claims matching for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) will begin on May 1, 2023. EVV claims with dates of service of May 1, 2023 and after that do not have an EVV visit match will deny. This includes EVV claims with in-home individualized skills and socialization.

As of Jan. 1, 2023, EVV is required for in-home individualized skills and socialization delivered in an own home/family home setting (OHFH). Program providers and Consumer Directed Services employers must comply with 1 TAC Chapter 354, Subchapter O, Electronic Visit Verification, regarding in-home individualized skills and socialization provided to an individual whose residential type is “own home/family home.”

EVV claims require the Texas EVV Attendant ID for in-home EVV individualized skills and socialization OHFH. Reference the document, HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF) or contact TMHP EVV Operations for questions related to the Texas EVV Attendant ID. The Staff ID is only required for the following residential types:

  • Host Home/Companion Care
  • Supervised Living (3 bed)
  • Residential Support Services (4 bed)

Reference the HCS and TxHmL Long-term Care Bill Code Crosswalk for more information about Staff ID requirements.

Reference the EVV Personal Care Services Bill Codes Table for specific billing codes which require EVV. The table is available in Excel and PDF formats on the EVV web page.

Email EVV Operations for questions.