Early Childhood Intervention (ECI) and Telehealth Services are not required to Use EVV

Date: April 17, 2024

Attention: Early Childhood Intervention and Telehealth Service Providers

Effective date: January 1, 2024

Call to action: The purpose of this communication is to inform applicable service providers that Early Childhood Intervention (ECI) and home health services delivered via Telehealth are not required to use EVV for dates of service on or after January 1, 2024.

Background: The Cures Act required states to implement Electronic Visit Verification (EVV) for Medicaid home health care services (HHCS) by Jan. 1, 2023. However, in July 2022, HHSC requested a good faith effort exemption from the Centers for Medicare and Medicaid Services to extend the deadline by one year. CMS approved the request and HHSC implemented EVV for Medicaid HHCS on Jan. 1, 2024.

How this impacts providers: The EVV claims matching process uses Healthcare Common Procedure Coding System (HCPCS) codes and modifier combinations, or other identifiers, to recognize HHCS services that are not required to use EVV and bypasses the claims matching process. The HCPCS codes and modifier combinations are listed on the EVV HHCS Service Bill Codes Table on the EVV 21st Century Cures Act web page.

Next step for Providers: TCHP will review claim denials for erroneous EVV denials of Telehealth and ECI claims and reprocess these claims without requiring any action from the program provider.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.