Electronic Visit Verification (EVV) is a federally required, but state-implemented, Medicaid regulation as part of the 21st Century Cures Act. It requires that organizations verify the time and place of Medicaid reimbursable services – ensuring that a clinician provides care at the patient’s place of service. This affects services paid for by Medicaid and Managed-Medicaid payers.

Unlike other states and aggregators, a state has requested that providers submit this data as part of the 837I claim. While we can support the sending of data as a claim attachment, The state has requested that agencies repurpose several existing fields for EVV-specific data. These include…

Effective July 01, 2023, in preparation for the CMS Mandate for Electronic Visit Verification (EVV) data required for Home Health (HH) 837I changes:

Page 12 - SV2 Segment, SV202-7 field

Page 12 - NTE Segment, NTE02 field

Page 14 – NM1 Segment, NM103 and NM104 fields

Page 14 – REF Segment, REF01 and REF02 fields

2400-Service Line

SV2-Institutional Service Line

SV202-7 - Description

For Home Health (HH) services (CLM05-1 Facility Type Code = 32 or 34), this field is required and is the time the services began and ended for EVV requirements. Format is HHMM-HHMM. HH will be 00 – 24 and MM will be 00 – 59. Example is 1130-1630 (11:30AM – 4:30PM). The time cannot exceed 24 hours based on the revenue line’s DOS and must be within 0000 – 2400 for a single day.

2400-Service Line

NTE-Third Party Organization Notes

NTE02 - Description

For Home Health (HH) EVV services

(CLM05-1 Facility Type Code = 32 or 34), additional data is required for the address where the services occurred. The format for this segment for Home Health EVV is as follows:

NTE*EVV-12345 SOMETHING DR-WILDBURN-VA-22554~

This provides the street, city, state, and ZIP information.

2420D-Referring Provider Name

NM1

NM103-Name Last

For Home Health (HH) EVV services (CLM05-1 Facility Type Code = 32 or 34), this field is required. This field is used to identify the Last Name of the HH Attendant delivering the services.

2420D-Referring Provider Name

NM1

NM104-Name First

For Home Health (HH) EVV services (CLM05-1 Facility Type Code = 32 or 34), this field is required. This field is used to identify the First Name of the HH Attendant delivering the services.

2420D-Referring Provider Secondary ID

REF

REF01-Reference Identification Qualifier

For Home Health (HH) EVV services (CLM05-1 Facility Type Code = 32 or 34), this field is required. The value for this element is LU (Location Number). This field is used to identify the type of identifier for the REF02 value associated to the HH Attendant delivering the services.

2420D-Referring Provider Secondary ID

REF

REF02-Reference Identification

For Home Health (HH) EVV services (CLM05-1 Facility Type Code = 32 or 34), this field is required. This field is used to identify the unique Attendant ID (not SSN or FEIN) for the HH Attendant delivering the services.