EVV and documentation for home care billing

What EVV is

Electronic visit verification is a way of recording, electronically, that a visit happened. CMS says the EVV system must be able to electronically verify:

• The type of service performed
• The individual receiving the service
• The date of the service
• The location of service delivery
• The individual providing the service
• The time the service begins and ends

The federal Medicaid context

Medicaid.gov says Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for Medicaid personal care services and home health services that require an in-home visit by a provider. CMS also says the law cannot be construed to require the use of a particular or uniform EVV system.

In practice that means your state Medicaid program sets the EVV method: which system or vendors are allowed, which services are covered, and how EVV data connects to your claims. Check with your state Medicaid agency. We do not publish state EVV tables or recommend vendors.

Private-pay visits

The Cures Act EVV requirement is about Medicaid services. A private-pay-only agency may not be covered by it, but your state, a contract or an insurer can still ask for visit records, and you need them to support every invoice. Check your state.

Documentation that supports the bill

• Time: when each visit started and ended, and who provided it.
• Tasks: what was done, in the form your state or payer requires.
• Signatures: client or caregiver sign-offs where your state or payer asks for them.
• Authorizations: the approval on file for payers that use one.

Your own planning; check your state and each payer for what they require. homecarepolicyprocedures.com, also published by Home Care Agency Blueprint, covers writing your documentation and records policies.

Keep only what you need to share

If HIPAA applies to you, HHS says the Privacy Rule generally requires covered entities to take reasonable steps to limit the use or disclosure of, and requests for, protected health information to the minimum necessary to accomplish the intended purpose. Decide with counsel whether it applies to your agency.