Skip to main content

Electronic Visit Verification (EVV)

Electronic Visit Verification (EVV) electronically verifies that service visits occur and documents the date and time service delivery begins and ends.

EVV Proprietary Systems

Last updated on 11/2/2022

An Electronic Visit Verification (EVV) proprietary system is an HHSC-approved EVV system that a program provider or Financial Management Services Agency (FMSA) may opt to use instead of an EVV vendor system from the state vendor pool that:

  • Is purchased or developed by a program provider or an FMSA.
  • Is used to exchange EVV data with the EVV Aggregator.
  • Complies with HHSC EVV Policy as it relates to EVV Proprietary Systems.
  • Complies with HHSC EVV Business Rules for Proprietary Systems.
  • Complies with the requirements of Texas Government Code Section 531.024172 or its successors.

An EVV Proprietary System Operator (PSO) is a program provider or FMSA that is approved to operate an EVV proprietary system.

Refer to the EVV Policy Handbook including Section 5000 EVV Proprietary System for more information.

EVV PSO Process Instructional Videos

The EVV PSO Process Instructional Video links below will provide a summary and key takeaways that will help you navigate the PSO Process.

EVV Proprietary System Operator (PSO) Onboarding Process

Program providers and FMSAs must complete, sign, and submit the EVV Proprietary System Request Form to start the approval process to become a PSO.

Program providers and FMSAs must select from the following onboarding paths based on the system they have chosen:

  • The Standard Path is for requesting approval to use an EVV system that has not been previously approved by HHSC.
  • The Expedited Path is for requesting approval to use an existing operational EVV system that HHSC has previously approved. Please refer to the EVV Proprietary Systems Approved by HHSC document for further information.

HHSC reviews submitted EVV Proprietary System Request Forms to assign an Operational Readiness Review (ORR) session. The ORR session is a validation process to determine approval for a PSO. ORR sessions are assigned based on the date of receipt of a complete and signed EVV Proprietary System Request Form.

The Proprietary System Operator Onboarding Process guide contains all of the details that a PSO needs to onboard their proprietary system in the Texas EVV operating environment. The Proprietary System Operator Onboarding Process refers to several documents that can be accessed through the links in the document or accessed directly below:

In order to use the automated features of the EVV Proprietary System Request Form (including the ability to select responses, the ability to use an electronic signature to sign the form, and the ability to submit the form to TMHP as an email attachment using the “Submit” button):

a) The user must successfully download/install Adobe Reader to their local computer.

b) The user must download and open the EVV Proprietary System Request Form in Adobe Reader.

If the user is unable to download the EVV Proprietary System Request Form, or is unable to successfully download/install Adobe Reader, the user may fill out the PDF form as before and print the completed form to manually sign and date the form.

EVV Proprietary System Request Form Effective Date: 07/11/2022

See the PSO Onboarding Process Overview and Timeline document for timeline and requirement differences between Standard and Expedited Path onboarding.

The program provider or FMSA must complete, sign, and submit the EVV Proprietary System Request Form to EVV_PSO@tmhp.com.

EVV Operational Readiness Review (ORR)

ORR Sessions

Session Path Business Rule Version Planning Meeting ORR Start Date Go-Live Date Range
Session 1 Expedited v2.0 1/5/2023 1/16/2023 4/3/2023-5/17/2023
Session 2 Expedited v2.0 1/26/2023 2/6/2023 4/24/2023-6/7/2023
Session 3 Standard v3.0 03/09/2023 3/20/2023 6/26/2023-8/1/2023

ORR Compliance Documents

Effective Date: 05/31/2022
Effective Date: 05/31/2022

HHSC EVV Business Rules for Proprietary Systems

The Business Rules document outlines the set of standards that a PSO must comply with as a condition of participation in the Texas Medicaid EVV Program. The standards cover guidelines for business processes related to EVV, and compliance with them is critical to producing successful outcomes for the program.

The guidelines govern the system set up (onboarding) for PSOs, the documentation and verification of services requiring EVV, the maintenance of the visit data, and transmission of the data to TMHP for inclusion in the EVV Aggregator.

The Business Rules document refers to several appendices that can be accessed through the links in the document or accessed directly below:

PSO Business Rules v2.0

EVV Business Rules Proprietary Systems V.2.0 (574 KB) Effective Date: 05/31/2022
Appendix A – HHSC EVV Reason Codes (78.36 KB) Effective Date: 1/01/2021
Appendix C – EVV Visit Transaction File (720.49 KB) Effective Date: 05/31/2022
Appendix E – Member Eligibility Companion Guides (227.61 KB) Effective Date: 05/31/2022
Appendix F – EVV Prior Authorization File (323.06 KB) Effective Date: 05/31/2022
Appendix G – EVV Standard System Reports (501.98 KB) Effective Date: 05/31/2022
Appendix J – Service Delivery Locations (171.53 KB) Effective Date: 05/31/2022
Appendix K – Texas-EVV Specific Terms (244.11 KB) Effective Date: 05/31/2022
Appendix L – Payer Plan Code Web Service (87.92 KB) Effective Date: 05/31/2022
Appendix M – EVV Visit Data Layout Edits Crosswalk (569.59 KB) Effective Date: 05/31/2022
Appendix N – EVV Data Transfer Guide (208.55 KB) Effective Date: 05/31/2022
Appendix O – Visit Maintenance (227.49 KB) Effective Date: 05/31/2022
Appendix P – Auto Verification (318.59 KB) Effective Date: 05/31/2022
Appendix Q – CDS Process Flow (95.89 KB) Effective Date: 05/31/2022

For questions about the EVV Business Rules, email EVVPSO@hhs.texas.gov.

To view archived appendices for the HHSC EVV Business Rules for Proprietary Systems, click here.

EVV Data Transfer

Vendors and program providers/FMSAs should use the EVV Data Transfer Guide to transfer data between vendors, between a vendor and a PSO, and between a PSO and a PSO.