Electronic Visit Verification (EVV): Service Codes that Require Use of an EVV System in Wisconsin

EVV is federally required for Medicaid-covered personal care, applicable supportive home care, and home health care services. This includes services authorized through Medicaid and BadgerCare Plus fee for service, HMOs, MCOs, and IRIS (Include, Respect, I Self-Direct). EVV information must be collected for care provided under the following service codes:

Personal care and supportive home care service codes that require EVV in Wisconsin

Service	Medicaid and BadgerCare Plus Fee-For-Service and BadgerCare Plus and Medicaid Supplemental Security Income (SSI) HMOs	Family Care and Family Care Partnership	IRIS	Live-in Worker Required by DHS to Capture EVV Information*
T1019: Personal care services; per 15 minutes	Yes	Yes	Yes	No*
T1020: Personal care services; per day	N/A	Yes	No	No*
S5125: Supportive home care; per 15 minutes	N/A	Yes	Yes	No*
S5126: Supportive home care; per day	N/A	Yes	Yes	No*
99509: Nurse supervisory visit; Home visit for assistance with activities of daily living and personal care; per visit	Yes	Yes	No	Yes

Home health care service codes that require EVV in Wisconsin

Service	Medicaid and BadgerCare Plus Fee-For-Service and BadgerCare Plus and Medicaid SSI HMOs	Family Care and Family Care Partnership	IRIS	Live-in Worker Required by DHS to Capture EVV Information*
92507: Treatment of speech, language, voice, communication, and/or auditory processing disorder; per visit	Yes	Yes	No	Yes
97139: Unlisted therapeutic procedure – Occupational therapy; per visit	Yes	Yes	No	Yes
97799: Unlisted physical medicine/rehabilitation service or procedure – Physical therapy; per visit	Yes	Yes	No	Yes
99504: Home visit for mechanical ventilation care; per hour	Yes	Yes	No	Yes
99600: Unlisted home visit service or procedure; per visit	Yes	Yes	No	Yes
S9123: Non-vent private duty nursing care in the home – by registered nurse; per hour	Yes	Yes	No	Yes
S9124: Non-vent private duty nursing care in the home – by licensed practical nurse; per hour	Yes	Yes	No	Yes
T1001: Nursing assessment/evaluation; per visit	Yes	Yes	No	Yes
T1021: Home health aide or certified nurse assistant; per visit	Yes	Yes	No	Yes
T1502: Administration of oral, intramuscular and/or subcutaneous medication by health care agency/ professional; per visit	Yes	Yes	No	Yes

*MCOs, HMOs, and provider agencies may independently require live-in workers to use EVV. Fiscal employer agencies for the IRIS program may not require participant-hired live-in workers to use EVV.

Personal care and supportive home care service codes that require EVV in Wisconsin

Home health care service codes that require EVV in Wisconsin

Glossary