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Electronic Visit Verification (EVV)

EVV hard launch

EVV hard launch for personal care and supportive home care services (service codes T1019, T1020, S5125, S5126) begins on May 1, 2023. Read the ForwardHealth Update.

What is EVV?

EVV is an electronic system that uses technology to verify that authorized services were provided. Workers will be required to send information at the beginning and end of each visit to an EVV system, including:

  • Who receives the service
  • Who provides the service
  • What service is provided
  • Where service is provided
  • Date of service
  • Time in and out 
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Stay up to date

Join Key Conversations—an informal, monthly drop-in session. DHS staff and EVV specialists will be available to answer questions about EVV.

  • April 17, 2023: 1–2 p.m. CT | Join online | Call in: 669-254-5252 and use webinar ID 160 112 5213
  • May 15, 2023: 1–2 p.m. CT | Join online | Call in: 669-254-5252 and use webinar ID 160 112 5213

New EVV claim edits virtual training for fee-for-service EVV administrators

Do you want to learn about how electronic visit verification (EVV) fits in the claim process? Do you want to understand the explanation of benefits language about your claims? Do you have questions about span billing and EVV? 

If you answered yes to any of these questions, please join us for a one-hour “Fee-for-Service EVV Administrator: Claim Edits” virtual training. Visit the Training Administrators page to learn more and register!

Wisconsin's EVV informational video

We invite you to watch and share our informational video about EVV. Sam Self-Determined and Pat Provider will walk you through the basics of EVV and answer some common questions.

 

 

New to EVV?

This step-by-step guide is for any provider agency preparing to use an EVV system to capture visit information for personal care and supportive home care services. It's available in English, Hmong, and Spanish.

Updates

EVV for home health care services

The federal 21st Century Cures Act requires states to implement EVV for Medicaid-covered home health care services (HHCS) by January 1, 2023. Federal statute allows a one-year extension if the state has made a good-faith effort to comply. The Wisconsin Department of Health Services (DHS) received the extension and therefore will implement EVV for HHCS by January 1, 2024. 

Proposed home health care service codes that will require use of an EVV system in Wisconsin include 92507, 97139, 97799, 99600, 99504, S9123, S9124, T1001, T1021, T1502, S9097, T1030, T1031: 

Home health care providers do not need to do anything or purchase anything to be in compliance with the EVV requirement at this time.

Please join our email list to receive updates about EVV as they become available.

 

Nurse sitting with a patient and making notes at home.
 

The Centers for Medicare & Medicaid Services (CMS) issued states additional guidance on EVV requirements. CMS provided states the flexibility to decide if live-in workers and services rendered in the community are subject to EVV requirements.

DHS policy decisions

  • DHS is not requiring EVV for live-in workers.​
  • DHS will require EVV for services regardless of where the services are provided, whether in the community, in the home, or both.
  • Managed care organizations (MCOs), health maintenance organizations (HMOs), and provider agencies may independently decide, based on business needs, if their live-in workers are required to use EVV.
  • IRIS Fiscal Employer Agents (FEAs) cannot require participant-hired live-in workers to use EVV.

Definition of a live-in worker

For the purposes of EVV, a live-in worker is a worker who either:

  • Permanently resides in the same residence as the member or participant receiving services, or
  • Permanently resides in a two-residence dwelling where the member or participant receiving services lives in the other half of the dwelling and is a relative of the member or participant receiving services.

Workers who do not meet this definition are not considered live-in workers. Live-in worker status must be established between each member and worker and verified at least annually. When a live-in worker provides services to more than one member with whom they permanently reside, live-in worker status must be validated for each member.

Examples of workers that are not considered live-in workers.

  • Workers who live with the member receiving services for only a short period of time, such as two weeks, are not considered live-in workers.
  • Workers who work 24-hour shifts, but are not residing with the Medicaid member “permanently” are not considered live-in workers.

This requirement affects all personal care and home health services, including services provided through:

  • Medicaid and BadgerCare Plus fee-for-service (ForwardHealth card)
  • BadgerCare Plus and Medicaid SSI HMOs
  • Family Care and Family Care Partnership
  • IRIS (Include, Respect, I Self-Direct)​

DHS will work to:

  • Maintain services provided, including community integration.
  • Support provider selection.
  • Keep an individual’s choice of a worker.
  • Ensure needed care is delivered.
  • Ensure data is secure and compliant with the Health Insurance Portability and Accountability Act (HIPAA).

Provider agencies, members, participants, workers, and program payers can contact Wisconsin EVV Customer Care for help with technical and program-related questions.

EVV Customer Care is also offering personalized office hours.

  • Agencies set up a one-on-one appointment with an EVV specialist who will talk through the agency’s specific challenges and help them find solutions.
  • The EVV specialist will come to the appointment with an understanding of where the provider agency is in the process, what issues they may be facing, and suggested solutions.
  • Office hours can be a one-time tool for getting started with EVV or solving a specific issue, or agencies can schedule regular office hour sessions with the same EVV specialist for ongoing support.

Contact Wisconsin EVV Customer Care by phone at 833-931-2035 or by email at vdxc.contactevv@wisconsin.gov.  Monday–Friday, 7 a.m.–6 p.m. CT.

Input from our stakeholders is essential to the successful implementation of EVV. Questions and comments can be emailed to vdxc.contactevv@wisconsin.gov or mailed to:

Division of Medicaid Services
Attention: Electronic Visit Verification
PO Box 309
Madison, WI 53707-0309

Pursuant to Section 12006(a) of the 21st Century Cures Act, which mandates that states implement EVV for all Medicaid personal care services that require an in-home visit by a provider

Last revised March 23, 2023