Electronic Visit Verification

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What is Electronic Visit Verification?

Electronic Visit Verification (EVV) is a system that home-based service providers are required to use by AHCCCS in pursuant to the 21st Century Cures Act. This will eliminate all paper timesheets across the state and help prevent fraud, waste, and abuse.

Who should use EVV?

The following provider types are required to use an EVV system when using a code subject to EVV:

Provider Description Provider Type
Attendant Care Agency 40
Behavioral Outpatient Clinic 77
Community Service Agency A3
Fiscal Intermediary F1
Habilitation Provider 39
Home Health Agency 23
Integrated Clinic IC
Non-Medicare Certified Home Health Agency 95
Private Nurse 46

You only need to utilize the EVV system you have in place while billing these codes:

Service HCPCS Service Code Service HCPCS Service Code
Attendant Care S5125 Respiratory Therapy S5181
Companion Care S5135/S5136 Speech Therapy G0153/S9128
Habilitation T2017 Private Duty Nursing S9123/S9124
Nursing G2099/G0300 Homemaker S5130
Home Health Aid/
Licensed Health Aid
T1021 Personal Care T1019
Physical Therapy G0151/S9131 Respite S5150/S5151
Occupational Therapy G0152/S0120 Skills Training and Dev H2014

EVV applies to specific when billing for places of services that include:

Places of Service Description POS Code
Home 12
Assisted Living Facility 13
Other 99
 

AHCCCS Forms – Required for Providers

Please utilize the AHCCCS form templates below; providers subject to Electronic Visit Verification are required to use the forms.

Claims

Claims submitted for services subject to EVV, will be denied if the EVV process is not followed. All qualifying claims are reviewed by the AHCCCS EVV system to determine if EVV criteria is met. The schedule, direct care worker’s clock in/outs and member validations will all provide data for the claims validation process.

The most common claim denial reasons are:

  • “No Visit Found”, which can happen when:
    • No record for the service(s) provided have been entered into the EVV system.         
    • 2 or more identical records are found (same provider, client, service, units, employee, start time and end time with both visits in a Verified or Processed state) within the results, this case will be assumed to be invalid.
  • “Unmatched Units” can happen when a visit or visits are found but the units are incorrect.

EVV Resources 

AHCCCS EVV