Electronic Visit Verification
Electronic Visit Verification (EVV) is a technology that allows caregivers to gather information about services that members receive in their homes. North Carolina is required to use EVV for certain home and community-based services, including NC Innovations and Traumatic Brain Injury (TBI) Waivers.
The 21st Century Cures Act requires NC Medicaid to use an Electronic Visit Verification (EVV) system for Personal Care Services (PCS) and Home Health Care Services (HHCS).
Personal Care Services (PCS)
State Plan PCS:
- Health Care Procedure Coding System (HCPCS):
- The Current Procedural Terminology (CPT) Code for PCS is 99509
- HA is used for anyone under 21 years old, regardless of setting
- HB is used for in-home care agencies, persons 21 years and older
- Possible procedure codes include: 99509HA AND 99509HB
Home and Community-Based Services (Behavioral Health Services)
- Community Living and Supports and Supported Living (b)(3) Services:
- Personal Care/Individual Supports
- Transitional Living Skills
- In-Home Skill Building
- Community Living and Supports
- Supported Living – Periodic
- Traumatic Brain Injury Waiver:
- Life Skills Training
- In-Home Intensive and Personal Care
Home Health Care Services
The 21st Century Cures Act requires NC Medicaid to begin using an EVV system for HHCS by July 1, 2023.
In compliance with the Cures Act, NC Medicaid determined that the following services covered through the State Plan and the 3A – NC Medicaid Home Health Services Clinical Coverage Policy will be subject to the EVV requirement:
- Aide Services
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Skilled Nursing Visits
EVV and Vaya Health
HHAeXchange (HHAX) is Vaya’s alternate EVV vendor solution for all EVV services. Claims for services subject to the EVV requirement must be submitted through HHAX.
Providers are required to send EVV information to Sandata, the EVV system used by NCDHHS. For assistance, contact the Sandata Customer Support Team by emailing firstname.lastname@example.org or by calling 1-855-940-4915.
Providers must register HHAX (or their own alternate EVV solution provider) with Sandata as their alternate EVV solution. HHAX has a job aid for registering an alternate EVV account with Sandata on their website. Follow the link below to download.
To contact Vaya with questions about EVV, email email@example.com or call Vaya’s Provider Support Line, open Mon. – Sat., 7 a.m. – 6 p.m., at 1-866-990-9712.
North Carolina Department of Health and Human Services EVV Updates
- NC Medicaid Electronic Visit Verification Revised Implementation Dates to Align with Transition of 1915(b) benefits to 1915(i) Authority
- NC Medicaid Home Health Services Alternate Electronic Visit Verification Live Instructor-Led Training Webinars | NC Medicaid (ncdhhs.gov)
For support, email firstname.lastname@example.org or email@example.com, or call 1-866-242-2465. Providers with an existing HHAeXchange portal can use the live chat feature available in the support center (recommended for quicker response times).