Electronic Visit Verification (EVV) will be required for Home Health Care Services (HHCS) as of January 1, 2024. The home health care services required to use EVV are found in the document, Programs, Services and Service Delivery Options Required to Use Electronic Visit Verification by January 1, 2024 (texas.gov). The EVV HHCS Service Bill Codes Table posted on the EVV 21st Century Cures Act webpage are in Excel and PDF formats.
Key Details:
Program providers and FMSAs must submit all HHCS EVV claims to Texas Medicaid and Healthcare Partnership (TMHP) starting with dates of service on or after December 1, 2023.
Community First will reject any HHCS claims with EVV services and dates of service on or after December 1, 2023, back to the program provider and FMSA directing them to submit the claim to TMHP for EVV claims matching.
All HHCS program providers and FMSAs that are new to EVV must register for a TexMedConnect account with TMHP. More information is located here: TMC_MCO_Only_BOOK.indb (tmhp.com)
Claims Matching
For dates of service on or after January 1, 2024, the EVV Aggregator will begin sending the actual match result for HHCS EVV claims to MCO’s, and MCO’s will process the claims accordingly (i.e., deny claims that receive EVV02 – EVV06 match codes). The actual claims match results will be viewable in the EVV Portal.
Action:
1. Register for TexMedConnect
Claims for MCO EVV services will be submitted to TMHP through TexMedConnect or through Electronic Data Interchange (EDI) using a Compass 21 (C21) Submitter ID.
· Access TexMedConnect through the TMHP website. To use TexMedConnect, you must already have an account on the TMHP website. If you do not have an account, set one up using the information provided in the TMHP Website Security Provider Training Manual.
· Program providers and FMSAs that need help setting up C21 or CMS Submitter IDs should contact the EDI Help Desk at 1-888-863-3638, Option 4.
2. Request EVV Portal Access
· To access the EVV Portal, program providers and financial management services agencies (FMSA) must have a TMHP User Account.
· Program provider and FMSA staff must contact their TMHP Provider Administrator to request EVV Portal access.
For full instructions, review the EVV Portal job aids on the EVV Learning Management System (LMS)
Community First Resources:
Contact:
Email ProviderRelations@cfhp.com or call 210-358-6294.