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Electronic Visit Verification Differential Adjusted Payment Notice

Date: 04/26/19

Beginning in  2020, AHCCCS will require Medicaid providers of personal care and home health services to use Electronic Visit Verification (EVV) pursuant to Section 1903 of the Social Security Act (42 U.S.C. 1396b).  EVV is an electronic based system that verifies when caregiver visits occur and documents the precise time services begin and end.  It ensures that members receive their medically necessary services. AHCCCS has selected Sandata Technologies LLC to deliver the statewide EVV system that will be made available to all service providers required to use EVV.  Service providers may choose to use an alternate EVV system vendor (at their own cost) and must interface with the statewide system as a data aggregator.  More information on AHCCCS’ plans for EVV is outlined on the AHCCCS website.

AHCCCS is requesting service providers, subject to EVV, complete the survey to inform readiness activities to support successful implementation of the EVV system.  Providers that complete the survey in its entirety and submit it by 05/20/19 will be eligible for a Differential Adjusted Payment (DAP) of 1.0% for all services subject to EVV for dates of service 10/01/2019 – 09/30/2020.  This means service providers will receive a 1% increase to their current rate for services during the period of 10/01/2019 – 09/30/2020.

The survey may be found here and attached is hard copy version of the survey to help providers prepare to answer the survey online.

The DAP is intended to incentivize providers to help AHCCCS and Sandata Technologies LLC prepare for the implementation of EVV.  The DAP is separate and apart from the State’s plans to fund the EVV system.  More information on the State’s plans to fund the EVV system may be found on the AHCCCS website.

For assistance in completing the survey, please email EVV@azahcccs.gov prior to the 05/20/19 deadline submission date.

The EVV DAP is applicable to the following provider types, service codes and Places of Service (POS) only when in combination with each other.  A qualifying service must be provided by a qualifying provider type and POS in order to qualify for the DAP.

Provider Description

Provider Type

Attendant Care Agency

PT 40

Behavioral Outpatient Clinic

PT 77

Community Service Agency

PT A3

Fiscal Intermediary

PT FI

Habilitation Provider

PT 39

Home Health Agency

PT 23

Integrated Clinic

PT IC

Non-Medicare Certified Home Health Agency

PT 95

Private Nurse

PT 46

 

Service

HCPCS Service Codes

DDD FOCUS Codes

Attendant Care

S5125

ATC

Companion Care

S5135

 

Habilitation (Hourly)

T2021

HAH, HAI

Home Health Services

(aide, therapy, and part-time/intermittent nursing services)

 

Nursing

Home Health Aide

Physical Therapy

Occupational Therapy

Respiratory Therapy

Speech Therapy

G0299 and G0300

T1021

G0151 and S9131

G0152 and S9129

S5181

G0153 and S9128

 

Private Duty Nursing (continuous nursing services)

S9123 and S9124

HN1, HNR

Homemaker

S5130

HSK

Personal Care

T1019

 

Respite

S5150 and S5151

RSP, RSD

Skills Training and Development

H2014

 

 

Place of Service Description

POS Code

Home

12

Assisted Living Facility

13

Other

99


AHCCCS EVV Updates

AHCCCS has selected Sandata Technologies, LLC as the statewide EVV vendor.  However, the contract award is contingent upon approval from the Centers for Medicare and Medicaid Services (CMS) and the Arizona Department of Administration, Arizona Strategic Enterprise Technology (ADOA-ASET).  Barring approval from CMS and ADOA-ASET, AHCCCS will be in a position to execute the contract with Sandata Technologies, LLC on or before June 1. 2019 and the date is subject to change.

That said, AHCCCS is not yet in a position to officially engage the provider community about requirements to comply with the EVV requirements.  Please make sure to sign up for the Constant Contact email notification to receive updates on recent EVV developments and next steps for the provider community.  Please click here to sign up for the email notifications.