Electronic Visit Verification (EVV) is a technology that allows caregivers to gather information about services members receive in their homes. NC Medicaid is required to use EVV for certain Home and Community-Based Services, including NC Innovations Waiver services. The 21st Century Cures Act requires NC Medicaid to use an EVV system for Personal Care Services (PCS) and Home Health Care Services (HHCS).
EVV and Vaya Health
HHAeXchange (HHAX) is Vaya’s alternate EVV vendor solution for all EVV services. Submit claims for services subject to the EVV requirement through HHAX.
Providers are required to send EVV information to Sandata, the EVV system used by the North Carolina Department of Health and Human Services (NCDHHS). For assistance, contact the Sandata Customer Support Team at nccustomercare@sandata.com or 1-855-940-4915.
Providers must register HHAX (or their own alternate EVV solution provider) with Sandata. For more information, review the HHAX job aid. To contact Vaya with questions about EVV, email provider.info@vayahealth.com or call the Provider Support Line at 1-866-990-9712, 7 a.m. to 6 p.m., Monday-Saturday.
Services subject to EVV requirements
State Plan PCS
- Healthcare Common Procedure Coding System (HCPCS): Current Procedural Terminology (CPT) Code for PCS is 99509
- Modifiers:
- HA is used for anyone under age 21, regardless of setting
- HB is used for in-home care agencies, individuals age 21 and older
- Possible procedure codes include 99509HA and 99509HB
Home and Community-Based Services
The following HCBS are subject to the EVV requirement:
- Personal Care
- NC Innovations Waiver:
- Community Living and Supports
- Supported Living – Periodic
- 1915(i) Services:
- Individual and Transitional Supports
- Community Living and Supports
Home Health Care Services
The following services covered through the Medicaid State Plan and NC Medicaid Clinical Coverage Policy 3A (Home Health Services) are subject to the EVV requirement:
- Aide Services
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Skilled Nursing Visits
EVV resources
NCDHHS
- Electronic Visit Verification (NC Medicaid)
- NC Medicaid Home Health Services Alternate Electronic Visit Verification Live Instructor-Led Training Webinars
- Home Health Services Electronic Visit Verification Implementation (NC Medicaid)
- NC Medicaid Electronic Visit Verification Revised Implementation Dates to Align with Transition of 1915(b) benefits to 1915(i) Authority
HHAeXchange
- HHAeXchange
- North Carolina Tailored Plans Provider Information Center
- North Carolina Home Health Information Center
- HHAeXchange Provider Knowledge Base
For support, enter a ticket in the HHAeXchange Client Support Portal. Providers with an existing portal account can use the live chat feature available (recommended for quicker response times).