Electronic Visit Verification

EVV Alerts

All Therap Users (HHCS and 1915(c) HCBS)

User Management: Provider administrators are required to audit and maintain their EVV users and assigned privileges within the Therap solution (if applicable) and the Therap Aggregator. Provider Administrators should review their agency user list and assigned user privileges every 90 days to ensure accuracy and update accordingly.

What Is Electronic Visit Verification?

Electronic visit verification (EVV) is an electronic system providers use to record information when delivering Personal Care Services (PCS), which includes certain in-home or community-based 1915(c) Home and Community Based Services (HCBS) or Home Health Care Services (HHCS). The use of EVV is a requirement of the Cures Act passed by Congress in 2016.

EVV must electronically verify six aspects of service delivery: the date, location and type of service, the individual providing the service, the individual receiving the service and the start and end times of the service.

EVV offers several benefits such as eliminating the need for paper documentation, creating flexibility in scheduling and delivering services, improved monitoring of participant health, safety and welfare and reduction in potential Medicaid fraud, waste and abuse.

Guiding Principles of EVV

DMS believes EVV should:

Simplify required documentation and reduce the administrative burden on Medicaid participants and providers.
Improve Medicaid participant health, safety and welfare.
Not reduce a Medicaid participant's services or alter chosen service delivery method.
Be developed with input from all stakeholders.
Include training for affected stakeholders.
Bring Kentucky into compliance with federal law.

EVV for HHCS

DMS implemented EVV for HHCS in Kentucky on Jan. 1, 2024. Effective Jan. 1, 2025, any HHCS claim without a corresponding visit documented using EVV will be denied. The following provider types and service codes are required to use EVV when delivering in-home HHCS to Medicaid participants.

Provider Types

Model II Waiver (MIIW)
Home Health Services (HH)
Private Duty Nursing (PDN)
HH or PDN services provided through a Managed Care Organization

Services

410 - Respiratory Therapist - MIIW
552 - Registered Nurse - MIIW
559 - Licensed Practical Nurse - MIIW
550 - Skilled Nursing - Home Health
560 - Medical Social Services - Home Health
570 - Home Health Aide - Home Health
T1000 - Private Duty / Independent Nursing - Private Duty Nursing

EVV PCS for 1915(c) HCBS Waivers

Traditional service provider agencies and financial management agencies (FMA) that bill certain in-home or community-based services must have direct service providers or participant-directed services employees enter visit information via EVV. This applies to five of Kentucky's six 1915(c) HCBS waivers: Acquired Brain Injury and Acquired Brain Injury Long Term Care, Home- and Community-Based, Michelle P. Waiver and Supports for Community Living. Read the Electronic Visit Verification - Affected Services document for a listing of services by waiver that must use EVV.

EVV Vendor

Providers have the option to use the state-sponsored EVV system or to use a third-party EVV system. Therap provides the state-sponsored system. It is available to providers at no cost. Providers that select a third-party system are responsible for all costs associated with it, ensuring their preferred systems meet the requirements of the Cures Act and ensuring full integration with Therap to allow DMS to reimburse for rendered services and conduct waiver quality assurance activities.