Electronic Visit Verification (EVV)
A State-by-State Guide

Centers for Medicare & Medicaid Services does not interpret the EVV requirement to apply to PACE program services. In CMS’s view, PACE is a separate Medicaid benefit listed at section 1905(a)(26) of the Social Security Act, and that provision is not cited in section 12006(a)(5)(C) of the Cures Act.

All services requiring an in-home visit that are included in claims under the home health category or personal care services category on the CMS-64 form are subject to the EVV requirement. In addition, services furnished under waivers or demonstration projects that meet the statutory or regulatory definition of a “home health service” or “personal care service” must meet the EVV requirement, even if they are bundled into a different service or furnished through a managed care provider. In other words, if the service includes personal care services or home health services, even if it has a different name or also includes other services, it is subject to EVV.

Section 1903(l)(5)(A) provides that the system must be able to electronically verify, with respect to visits conducted as part of personal care services or home health care services, the following:

• Type of service was performed
• Individual receiving the service
• Date of the service being provided
• Location of service delivery
• Person providing the service
• Time the service begins and ends

Section 1903(l)(2) also requires states to provide for a stakeholder process to allow input into the state’s implementation of the EVV requirement from providers of PCS and home health services, beneficiaries, family caregivers and other stakeholders.

No. There is no mandate for that. States have significant discretion to choose the EVV system as per their needs. However, it should collect all of the statutorily mandated information on personal care and home health care services that requires an in-home visit by a care provider. Centers for Medicare & Medicaid Services (CMS) does not endorse or recommend any specific type of EVV system.

The following is a high level summary of anticipated changes with the implementation of EVV:

Agencies need to implement EVV before the new deadline in Virginia that is June 30, 2020.