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.