Electronic Visit Verification (EVV)
Section 120006(a) of the 21st Century Cures Act (2016) mandates that states implement Electronic Visit Verification (EVV) for all MassHealth (Medicaid) personal care services (PCS) and home health care services (HHCS) that require an in-home visit by a provider. In Massachusetts, EVV is required for MassHealth and the Executive Office of Aging & Independence.
The Executive Office of Health and Human Services (EOHHS) administers the Massachusetts Medicaid program, MassHealth, and oversees the use of EVV in programs that provide certain home- and community-based services. EOHHS has contracted with Sandata Technologies to operate Massachusetts’s EVV system.
Federal law requires that providers use the EVV system to document the following information:
- Date of service
- Location of service
- Individual providing service
- Type of service
- Individual receiving service
- Time the service begins and ends
What is EVV?
EVV uses technology to electronically record when a caregiver begins and ends in-home services with a MassHealth (Medicaid) member. These systems require a device, such as a smartphone, GPS-enabled tablet, or landline, to collect the caregivers’ start and end times.
For questions related to EVV implementation in Massachusetts, please contact the EVV Implementation at [email protected] or visit EVV | Mass.gov.
Who is Sandata?
Commonwealth Care Alliance® (CCA) is working with Sandata to leverage their software platform for the EVV solution for CCA providers in Massachusetts.
Sandata supports end-to-end EVV, including data aggregation and claims validation, enabling compliance with the 21st Century Cures Act.
CCA, in partnership with Sandata, accepts billing for the following services:
- Personal care under 21
- Personal care over 21
- In-home respite
Please visit the Sandata website for more information about EVV. Providers may also call or email Sandata for additional support.
- Phone: 1-833-511-0164
- Email: [email protected]
MassHealth Medicaid and CCA require the use of EVV for the following provider types and procedure codes:
EOHHS Provider Types:
58 (Fiscal Intermediary Services)
59 (Personal Care Management Agency)
60 (Home Health Agency)
62 (Group Adult Foster Care [No AFC])
68 (Home Care Corporation)
98 (Special Programs)
| HCPCS Code | Service Description | Modifiers |
|---|---|---|
| Acquired Brain Injury (ABI)/Moving Forward Plan (MFP) Waivers | ||
| G0156 | Home Health Aide | U4 or U8 |
| G0299 | Skilled Nursing – RN | U4, U5, U8, or U9 |
| G0300 | Skilled Nursing – LPN | U4, U5, U8, or U9 |
| S9128 | Speech Therapy (in home setting) | U4, U5, U8, or U9 U1 or U2 |
| S9129 | Occupational Therapy (in home setting) | U4, U5, U8, or U9 U1 or U2 |
| S9131 | Physical Therapy (in home setting) | U4, U5, U8, or U9 U1 or U2 |
| T1004 | Supportive Home Care Aide | U4 or U8 |
| T1019 | Personal Care | U4 or U8 U1, U2 or UB |
| Home Health (HH) | ||
| G0151 | Physical Therapist in Home Health Setting | |
| G0152 | Occupational Therapist in Home Health Setting | |
| G0153 | Speech Language Pathologist in Home Health Setting | |
| G0156 | Services of HH Aide in Home Health Setting | |
| G0156 | HH – HH Aide ADL Only Support in Home Health Setting | UD |
| G0299 | Direct Skilled Nursing Services of an RN | UD, U1, U2 or GT |
| G0299 | Telehealth-Direct Skilled Nursing Services of an RN | GT |
| G0300 | Direct Skilled Nursing Services of an LPN | UD, U1, U2 or GT |
| G0493 | HH – RN Observation and Assessment Visit HH | |
| T1022 | RESTRICTED FOR HH ONLY RN specialized services in patient home | |
| T1502 | Admin of Oral, Intramuscular, Subcutaneous Med | GT |
| T1503 | Administration of Medication Other than Oral and/or Injectable | |
| 99509 | Emergency PCA by Home Health Agency | |
| Non-Waiver/State Home Care (Enhanced Community Options Program/Home Care Percent Based/Home Care Basic/Respite Over Income) | ||
| G0156 | Services of HH Aide in Home Health Setting | |
| G0299 | Complex Care Training and Oversight by an RN | UB |
| G0300 | Complex Care Training and Oversight by an LPN | UB |
| S5125 | Supportive Home Care Aide, 15 min. | UB |
| S5130 | Homemaker, 15 min. | UB |
| S5135 | Companion, 15 min. | UB |
| S5135 | Telehealth – Companion, 15 min. | UB, U1 |
| S9129 | Home Safety/Independence Evaluation by an OT | UB |
| T1019 | Personal Care, 15 Min | |
| Frail Elder Waiver (FEW) (Choices/Home Care Basic Waiver) | ||
| G0156 | Services of HH Aide in Home Health Setting | |
| G0299 | Complex Care Training and Oversight by an RN | UB |
| G0300 | Complex Care Training and Oversight by an LPN | UB |
| S5125 | Supportive Home Care Aide, 15 min. | UB |
| S5130 | Homemaker, 15 min. | UB |
| S5135 | Companion, 15 min. | UB |
| S5135 | Telehealth – Companion, 15 min. | UB, U1 |
| S9129 | Home Safety/Independence Evaluation by an OT | UB |
| T1019 | Personal Care, 15 Min | |
| Senior Care Option (SCO) Frail Elder Waiver (FEW) | ||
| G0156 | Services of HH Aide in Home Health Setting | |
| G0299 | Complex Care Training and Oversight by an RN | UB |
| G0300 | Complex Care Training and Oversight by an LPN | UB |
| S5125 | Supportive Home Care Aide, 15 min. | UB |
| S5130 | Homemaker, 15 min. | UB |
| S5135 | Companion, 15 min. | UB |
| S5135 | Telehealth – Companion, 15 min. | UB, U1 |
| S9129 | Home Safety/Independence Evaluation by an OT | UB |
| T1019 | Personal Care, 15 Min | |
| Group Adult Foster Care (GAFC) | ||
| H0043 | GAFC – Per Diem Visit | |
| Self-Directed | ||
| T1019 | Personal Care, 15 Min | |
| Personal Care Attendant (PCA) | ||
| T1019 | Personal Care, 15 Min | |