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Clarification Update: 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 claims matching for Home and Community-based Services and Texas Home Living 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 email TMHP EVV Operations for questions related to the Texas EVV Attendant ID.

Clarification Update:

Using the Texas EVV Attendant ID satisfies the HCS and TxHmL requirement to use the Staff ID when billing for the following residential settings that do not require EVV:

  • 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. Note: If there is an entry in the Line Item Control Number (LICN) field in the crosswalk, and the service is EVV, then a Texas EVV Attendant ID is required.

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.

Contact EVV Operations if you have any questions.