Electronic Visit Verification Program Manual

Official guidance for the Colorado Electronic Visit Verification (EVV) Program

Last updated: 12/8/2020
  1. EVV Program Glossary

    1. Participants

      1. Member
        Member is an actively enrolled Health First Colorado recipient of EVV-required services. The member is referred to as the ‘Client’ in both the State EVV Solution and Provider Choice System.
      2. Direct Care Worker
        Direct Care Worker, also known as Caregiver, is the person providing a service to a member. The Direct Care Worker is often an employee of a Provider.
      3. Provider
        Provider is an actively enrolled Health First Colorado provider billing for EVV- appropriate services.

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    2. General

      1. The 21st Century Cures Act

        The 21st Century Cures Act, also known as the Cures Act, is Federal statute "to accelerate the discovery, development, and delivery of 21st century cures, and for other purposes." Section 12006 of the Cures Act mandates State Medicaid agencies to use Electronic Visit Verification.

      2. Electronic Visit Verification (EVV)

        EVV means the use of technology, including mobile device, telephony, or manual visit entry, to verify the required data elements related to the delivery of Health First Colorado Services as mandated by the 21st Century Cures Act and CCR 2505-10 Section 8.001.

      3. Colorado "Open Choice" or "Hybrid" Model

        An Open Choice or Hybrid EVV model means that in Colorado a provider agency may choose to use the State EVV Solution at no cost or utilize a Provider Choice System. Providers who choose to utilize a Provider Choice System must ensure that their system is configured to Colorado EVV rules and requirements.

      4. State EVV Solution

        State EVV Solution means the portion of the Colorado hybrid implementation model that is made available by the Department. The State EVV Solution includes the Mobile Visit Verification (MVV) Application, Telephonic Visit Verification (TVV) System, the Provider EVV Portal, and the optional Scheduling module (see Technical Definitions). The Department utilizes Sandata for the State EVV Solution and the solution is offered at no cost to providers.

      5. Provider Choice System

        Provider Choice System means the portion of the Colorado hybrid implementation model chosen by providers to submit EVV data. In some cases, providers may choose to add an EVV component to an administrative technology already in use. All contracted technologies must complete interface testing with Sandata and providers must complete Data Aggregator training. Provider Choice Systems are paid for by the Provider, satisfy all requirements as defined in rule, are compatible with the State EVV Solution interfacing, and are consistent with Federal and State law.

      6. Verification Data Points

        Verification Data Points mean the essential points of data that all EVV records must have to be considered a viable EVV. The federally required points and their corresponding definitions in Colorado are:

        Federally Required Point of Data Corresponding Definition in Colorado
        The type of service performed EVV Type of Service is a designation given to a group of appropriate codes for a type of service delivered. Full information is in the EVV Type of Service section of this manual.
        The individual receiving the service

         

        The individual receiving the service is the Member as clarified in the Participant Definitions of this manual
        The date of the service The date of the service
        The location of service delivery A location may be a mailing address, GPS coordinates, or a uniquely identified location. A uniquely identifiable location example is "Colorado State Capital Building"; recording "Doctor’s office" is not uniquely identifiable and is therefore not an acceptable location record.
        The individual providing the service The Direct Care Worker as clarified in the Participant Definitions of this manual. Direct Care Workers are affiliated with a Provider as clarified in the Participant Definitions of this manual.
        The time the service begins and ends The time that a service begins and the time the time that a service ends, as recorded utilizing EVV technology at the time of service.

        EVV records also contain additional points, like sequence identifiers which indicate the order in which records are updated. All Verification Data Points are listed in the Technical Specification Documents section of the EVV Provider Choice Systems web page.

      7. Threshold

        Threshold means the Department-defined acceptable limit of modified and manual EVV records determined as a percent of paid claims.

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    3. Operational Use

      1. Sandata Welcome Letter

        Welcome email from Sandata sent to the provider’s Service Email Address after training has been complete. The Sandata Welcome Letter includes Sandata credentials for entry into the State EVV Solution Provider EVV Portal or Provider Choice EVV Solution Data Aggregator.

      2. Unmodified EVV

        Unmodified EVV is an EVV captured by a caregiver with all Verification Data Points at the time of service and remains unmodified in any way.

      3. Modified EVV

        Modified EVV is an EVV record with one or more of the Verification Data Points captured or modified after the time of service.

      4. Exception

        Exception means an alert identifying a missing Verification Point of Data. All Exceptions must be fixed for an EVV record to be a verified visit.

        Exceptions may be fixed in the Visit Maintenance module of the State EVV Solution. For Provider Choice functionality contact your vendor.

      5. Alternate Location

        An Alternate Location means a modification that corrects the location recorded at the time of service or enters an otherwise unrecorded location. See Alternate Locations Guidance for more information.

      6. Manual Visit Entry (Manual EVV)

        Manual Visit Entry means an EVV record input in the Provider EVV Portal after the time of service delivery by administratively entering all Verification Points of Data.

      7. Verified Visit

        A verified visit does not contain any exceptions, meaning either no exceptions exist, or they have been fixed, making the visit eligible for claim matching.

      8. Matched Visit

        A matched visit is an EVV record that has matched to a billed claim. A matched visit requires a verified visit EVV record and a billed claim that has no other claim errors that has paid correctly. EVV records that are not yet a verified visit will not match. Billed claims that have not paid (for any reason, not just EVV matching) will not match.

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    4. Program Integration

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      1. Remittance Advice (RA)

        The RA contains a weekly summary of all claims submitted and is available the Monday following the end of the claim submission cycle. For more information on reading and downloading your Remittance Advice, refer to the Provider Web Portal Quick Guides web page.

      2. Service Email Address

        Email contact located in the DXC Provider Portal titled "Service Email Address". The Service Email Address is utilized for sending the Sandata Welcome Letter containing Sandata credentials for entry into the system. Refer to the Provider Maintenance Provider Web Portal Quick Guide, available on the Quick Guides web page, for guidance on updating this email in the DXC Provider Web Portal.

      3. Mailing Email Address

        Email contact located in the DXC Provider Portal titled "Mailing Email Address". The Mailing Email Address is utilized for sending DXC communications including updates on the EVV Program. Refer to the Provider Maintenance Web Portal Quick Guide, available on the Quick Guides web page, for guidance on updating this email in the DXC Provider Web Portal.

      4. Explanation of Benefits (EOB) 3054

        Informational message on provider-specific Remittance Advice (RA) designating that a claim billed with an EVV-applicable code does not have a corresponding visit recorded through an EVV system. See Remittance Advice (RA) for more information on viewing claim lines that have received this message.

    5. Technical Definitions

      1. Direct Care Worker ID

        Direct Care Worker ID, or Employee ID, identifies the Direct Care Worker providing services and is automatically generated for the State EVV Solution. See Colorado Addendum for specific value for Provider Choice systems. See Training Participant Guide for usage.

      2. Exception ID

        Exception IDs identify Exceptions that are created in the EVV systems. Specific Exception IDs are located in the supplemental training materials for the State EVV Solution and in the Colorado Addendum for Provider Choice Systems.

      3. Provider EVV Portal

        The Provider EVV Portal is the web-based administrative tool used to manage EVV activity, add Manual Visit Entry data elements, and to monitor all activity recorded in the EVV System. For Provider Choice Systems, please contact EVV vendor for specific information.

      4. Data Aggregator

        Data Aggregator is the read-only portal for Provider Choice System users. Visit data will be reflected from the Provider EVV Portal. Information in the Data Aggregator can only be updated by submitting new EVV information to the Department.

      5. Mobile Visit Verification (MVV App/SMC App)

        Mobile Visit Verification is a smart phone or mobile device application used by the Direct Care Worker to record visit data at the start and end of the visit.

      6. Reason Code

        Reason Codes are standard codes established by the Department used to explain (or, as stated in the Sandata training manuals, "acknowledge") an Exception. Reason Codes are located in the supplemental training materials for the State EVV Solution and in the Colorado Addendum for Provider Choice Systems.

      7. Telephonic Visit Verification (TVV)

        TVV is a functionality for Direct Care Workers to record an EVV visit calling in with a telephone. Each provider agency using the State EVV Solution is provided with two toll- free telephone numbers for use by Direct Care Workers to record visit data at the start and end of a visit. For Provider Choice System functionality please contact your vendor.

        Colorado allows the use of both landlines and cell phones to submit TVV records. EVV systems (either State Solution or Provider Choice System) must automatically record a specific address as the telephone is used and locations must be updated to reflect the actual location of service delivery as needed.

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  2. EVV Program Overview

    1. Colorado EVV

      Electronic Visit Verification (EVV) is mandated (effective August 3, 2020) in Colorado by 10 CCR 2505-10 Section 8.001 and Section 12006(a) of the 21st Century Cures Act. Federal guidance requires EVV for Home and Community Based Services (HCBS) that include an element of Personal Care Services and State Plan Home Health Care Services. Colorado requires the use of EVV for several other services that are similar in nature and delivery to the federally mandated services. These additional services are included to enhance care coordination, promote quality outcomes for members, and to streamline requirements for providers. Specifically, EVV will be required for the following:

      EVV requirements are the responsibility of providers billing services to the Department of Health Care Policy & Financing (the Department). The impact to most members is minimal, however members who utilize CDASS and employ attendants will be required to complete training and comply with EVV requirements.

      The Colorado EVV Program has implemented an Open Choice Model, meaning that providers may use the State EVV Solution or a Provider Choice EVV System.

      The Department has worked with providers and other stakeholders throughout the design of the EVV Program and has made several changes both to the system and policy to incorporate stakeholder feedback. The Department established an Electronic Visit Verification web page to share policy and system updates and engagement opportunities, held multiple stakeholder meetings from September 2017 through the present, and held specific engagement sessions for Code of Regulations feedback. Additional information on stakeholder engagement can be found on the EVV Stakeholder Workgroup web page.

      • Behavioral Therapies
      • Consumer Directed Attendant Support Services (CDASS)
      • Home Health
      • Homemaker
      • Hospice
      • Independent Living Skills Training (ILST) and Life Skills Training (LST)
      • In-Home Support Services (IHSS)
      • Occupational Therapy
      • Pediatric Behavioral Therapies
      • Pediatric Personal Care
      • Personal Care
      • Physical Therapy
      • Private Duty Nursing
      • Respite and Youth Day
      • Speech Therapy
      • State EVV Solution: The Department provides an EVV system for provider use at no cost. The State EVV Solution is built specifically to collect EVV records and may be (optionally) used for scheduling care.
      • Provider Choice EVV System: Providers may choose to use a Provider Choice EVV system that interfaces their choice of technology with the State EVV Solution. This is especially useful for providers that already use an administrative suite of technology that can incorporate EVV records into existing records and practices. Any costs associated with using a different EVV system will be borne by the provider.

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    2. Colorado EVV Exclusions

      EVV is intended to be used for the services mentioned above when provided in a visit-based fee-for service setting. While EVV records may still be collected (meaning the Department does not prohibit the collection of records in these circumstances), EVV records are not required when services are delivered through the following ways:

      • Child Health Plan Plus (CHP+): CHP+ is public low-cost health insurance for certain children and pregnant women. It is for people who earn too much to qualify for Health First Colorado (Colorado's Medicaid Program), but not enough to pay for private health insurance.
      • Live-in Caregivers: The Department recognizes the unique nature of service delivery for Live- in Caregivers. For an EVV exemption, Live-in Caregivers must meet all requirements as stated in the Department Operational Memo 20-051 "Electronic Visit Verification Live-In Caregiver Exception" and the Live-in Caregiver Attestation Form, available on the Electronic Visit Verification web page in English and Spanish.
      • Non-Fee for Service: Members receiving care through capitated payment models including through the Regional Accountable Entities (RAEs), Managed Care Organizations (Denver Health Medicaid Choice and Rocky Mountain Health Plan's Prime), or capitated behavioral health benefits administered by the RAEs.
      • Program of All-Inclusive Care for the Elderly (PACE): The PACE program provides comprehensive medical and social services to certain frail individuals 55 years of age and older. The goal of PACE is to help individuals live and stay in their homes and communities through comprehensive care coordination.
      • State Supported Living Services (State SLS): State SLS services mirror SLS waiver services for normally ineligible members and do not use normal billing methodology.

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    3. Colorado EVV Restrictions

      EVV assures that care is delivered at the time of service by collecting six points of data. The Department, in coordination with stakeholders, has developed restrictions enforced in both system design (the State EVV Solution can not violate these restrictions and Provider Choice Systems must be set up to not violate these restrictions) and policy (these restrictions are specified in 10 CCR 2505-10 8.001, known as the "EVV Rule"). Providers or technology systems are encouraged to contact the Department (evv@state.co.us) for clarifications around these restrictions. Restriction violators should be reported to the Department for enforcement. The following practices are prohibited in the Health First Colorado EVV Program:

      • The Department will not allow or accept biometric data, pictures, video, or voice recordings to identify members or substantiate Health First Colorado visit data.
      • The Department will not allow or accept visit data that includes continual GPS tracking during a visit and will only accept location information at the beginning and/or end of a Health First Colorado visit.
      • The Department will not utilize geo-fencing to restrict location of Health First Colorado service delivery.

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  3. Enrollment

    1. Member Enrollment

      Members receiving services that require EVV must be administratively entered into the Provider EVV Portal for each Provider Agency collecting EVV records. Members and Providers must work together to ensure that information is correct and viable. Providers Agencies are responsible for the maintenance of all caregiver information. CDASS members should work directly with their FMS vendors.

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    2. Caregiver Enrollment

      Caregivers utilizing EVV must be administratively entered into the Provider EVV Portal by each Provider Agency collecting EVV records for services rendered. Caregivers and providers must work together to assure that information is correct and viable. Providers Agencies are responsible for the maintenance of all caregiver information.

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    3. Provider Enrollment

      Providers billing for EVV-services must be enrolled with the EVV program for each unique Provider Health First Colorado ID (Medicaid ID). EVV enrollment may be automatically included in your new Medicaid enrollment depending on the nature of the codes regularly billed by the provider type and specialty. Provider types and specialties who do not have EVV enrollment automatically included in their Medicaid enrollment but are planning to bill, or are already billing EVV codes (see EVV Types of Service – Service Code Inclusions), may submit an Electronic Visit Verification Attestation Form to have EVV enrollment added to their Medicaid enrollment. Providers may use this Electronic Visit Verification Attestation Form during initial enrollment or as a maintenance update to their current enrollment. The Electronic Visit Verification Attestation Form can be found under Provider Enrollment & Update Forms drop-down section of the Provider Forms web page. For more information on Provider Maintenance to a current enrollment, refer to the Provider Maintenance Web Portal Quick Guide, available on the Quick Guides web page.

      1. Multiple EVV enrollments

        Agencies with multiple Health First Colorado Provider (Medicaid) IDs can bypass additional training for each ID associated with the agency. This can be done if one Health First Colorado Provider (Medicaid) ID has fully completed training and received credentials for the State EVV Solution or the Sandata Data Aggregator (Provider Choice EVV Solution Training).

        For those who would like to bypass additional training and have already completed training for one Provider Health First Colorado ID (Medicaid ID), additional credentials can be requested by contacting Sandata at cocustomercare@sandata.com or (855) 871-8780.

      2. Training

        Providers enrolled in the EVV program must complete necessary training to receive EVV credentials. Training must be completed for both the State EVV Solution and Provider Choice EVV Solution. For more information on training visit the Electronic Visit Verification web page.

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  4. Provider Guidance

    The following guidance may be used to implement EVV successfully:

    1. Alternate Locations

      A modification that corrects the location recorded at the time of service or enters an otherwise unrecorded location is defined as an Alternate Location. Alternate Locations are used in the following situations:

      Provider Responsibilities

      Provider agencies must ensure the location for an EVV record is correct. A location may be a mailing address, GPS coordinates, or a uniquely identified location. (A uniquely identifiable location example is "Colorado State Capital Building"; recording "Doctor’s office" is not uniquely identifiable and is therefore not an acceptable location record.)

      Provider agencies must maintain records supporting both the validity and appropriate use of Alternate Location.

      Alternate Location in State EVV Solution

      Providers may refer to Appendix A: Alternate Location Guidance for State EVV Solution for detailed methodology.

      Alternate Location in Provider Choice EVV Solutions

      Providers utilizing a Provider Choice EVV Solution must ensure that a correct location of service delivery is submitted to the Department. Providers should ask their EVV vendor how to correct or input location of service delivery within their EVV system. Providers are responsible for reviewing and ensuring accuracy of EVV data submitted to the Department through the Data Aggregator.

      • Correcting any method of EVV collection that recorded the location incorrectly.
      • Modifying an existing EVV record to update a previously entered location.
      • Entering a Manual Visit into the Provider EVV Portal.

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    2. Billing Integration

      EVV records do not bill the Department directly. Claims should still be submitted to the Department according to Department guidance. EVV records collected by the State Solution or transmitted to the State Solution by a Provider Choice system will be transmitted to the Department’s fiscal agent to match against claims during adjudication. EVV records will then match to claims lines submitted to the Department as an additional requirement for claims to process correctly.

      If an EVV record is modified after a claim line is matched for payment, the provider is responsible for voiding the matched claim and resubmitting for payment to ensure the correct EVV matches to the billed claim. For information on how to void and resubmit a claim, please refer to Department guidance.

      Visit records in the State Solution are transmitted nightly. Visits are available for matching in the DXC Claims System the day after a visit is recorded and verified. Please be aware that claims must be billed after service has been completed and a visit has been recorded to ensure proper matching.

      For more information on the DXC payment processing schedule please refer to the Billing Training Resources drop-down section on the Provider Training web page.

      Providers may review Remittance Advice for EOB 3054 to assure that claims will pay as intended after January 1, 2021. For more information on reading and downloading your Remittance Advice, refer to the Provider Web Portal Quick Guide on the Quick Guides web page.

      If, as a billing provider, your claim didn't match to a visit, this means that you are incorrectly entering one of the points of data being captured in the EVV system, or you submitted your claim prior to having a visit available for matching. To see why this occurred, you'll need to look at which claim lines did not have a matching visit. To do this, download your Remittance Advice. Next, you will need to log into the Sandata provider portal (for State Solution users) or the Sandata Aggregator (for Provider Choice systems) and find the visits that were logged for those claim lines. Next, check the following points of data to see which is the cause of the missing visit(s):  

      1. Billing Provider Medicaid (Location) ID - does the claim location ID match the location ID for your STX account? If you're unsure which ID was used to train, you can contact Sandata and confirm this information. The billing provider ID used to submit the claim must match the billing ID for your STX account where the visit is logged. Note: If you have more than one billing ID, you will need additional STX accounts for unique matching.  

      2. Client Medicaid ID - does the Client Medicaid ID on the claim match the Client Medicaid ID on the visit? If the Client Medicaid ID on the visit is mistyped, the visit will not match to the claim.  

      3. Dates of Service - does the first and last dates of service match the visit's start and end dates?  

      4. Service Grouping - does the claim procedure or revenue code (and any applicable modifiers) match the correct grouped code on the visit? If you're unsure which group code you need to select, see the EVV service code list and EVV Crosswalk of Codes to find the grouped code you should select. Note: Verify you are looking at the right code as some groupings sound similar. Ex. 'HHOT' (Home Health - Occupational Therapy) will be a different service than 'OT' (Occupational Therapy)  

      5. Submission Date - when was the claim submitted? Visits are sent nightly for claims matching and only verified visits can match to claims. Ensure that claims are billed the day after a visit has been verified. Note: If you fix an exception and the visit becomes verified, you still need to wait until the next day to bill for that claim.  

      6.  

        ICN Claim Number - to find your ICN claim number, pull your Remittance Advice (RA) and search for the services that you received EOB 3054 for. See the Quick Guide section of the HCPF website for information on how to pull your RA and how to read your RA

      7. Visit ID - to find your visit ID, log into the Sandata Aggregator (if using Provider Choice System) or Sandata Portal (if using State Solution) and navigate to the Reports section on the left hand side. Choose ‘Date Range Reports’ in report type and choose ‘Detail Visit Status’. Select the timeframe for the visit and run the report. The first column on the report will be the visit ID. Find the visit in question and the corresponding visit ID.

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    3. Compliance Timeline

      The Colorado EVV Program both made the State EVV Solution available and allowed providers to use Provider Choice Systems to submit EVV records beginning on October 1, 2019.

      On August 3, 2020, the use of EVV was mandated by Colorado Code of Regulation. As required by the 21st Century Cures Act and according to the plan approved by the Colorado Joint Budget Committee, on January 1, 2021, all claims requiring the use of EVV will encounter a pre-payment review process. Claims without corresponding EVV records will deny during claims adjudication.

      The Department is utilizing a tiered implementation strategy to familiarize providers with the use of EVV before incorporating claims adjudication to minimize long-term administrative burden and reduce the financial impact when claims require EVV records on January 1, 2021. The Department has issued guidance through Operational Memo 20-079 advising providers of the following stages of EVV implementation:

      August 3, 2020 – Compliance Monitoring

      October 1, 2020 – Over-Payment Review

      January 1, 2021 – Pre-Payment Claim Adjudication

      Provider Options for Compliance

      Providers may utilize multiple strategies to assure compliance at appropriate times and are advised of options that may be useful in implementing EVV in a timely manner.

      • The EVV Rule (10 CCR 2505-10 8.001.3.E.1.a) states: "Providers that fail to comply with this rule after August 3, 2020, may be subject to Compliance Monitoring and a Request for Written Response in accordance with Section 8.076."
      • Beginning August 3, 2020, all claims submitted to the Department that require EVV records will be reviewed for corresponding EVV.
      • Providers that are not using EVV after August 3, 2020, must submit a written plan to the Department outlining their intent to utilize EVV and when compliance is expected.
      • The EVV Rule (10 CCR 2505-10 8.001.3.E.1.b) states: "Providers that fail to comply with this rule after October 1, 2020, may be subject to Compliance Monitoring, Request for Written Response, or Overpayment Recovery."
      • Beginning October 1, 2020, in addition to the August 3, 2020 enforcement requirements, all claims submitted to the Department that require EVV records will be reviewed for corresponding EVV.
      • All claims subject to EVV requirements will pay initially, even if no EVV record is on file to match to the claim.
      • Paid claims that do not have valid matching EVV records may be subject to Department review and recoupment as Over-Payment Recovery.
      • The EVV Rule (10 CCR 2505-10 8.001.3.E.1.c) states: "Providers that fail to comply with this rule after January 1, 2021, may be subject to Compliance Monitoring, Request for Written Response, Overpayment Recovery, Denial of Claims, Suspension, Termination, or Nonrenewal of their Colorado Medicaid Provider Agreement in accordance with Section 8.076."
      • Beginning January 1, 2021, in addition to the October 1, 2020, enforcement, all claims submitted to the Department that require EVV records must be matched to valid EVV records to pay.
      • Due to the unique federally-mandated payment structure for Hospice services, Hospice services are exempt from Pre-Payment Claim Adjudication. Hospice services are subject to Compliance Monitoring and Over-Payment Review only.
      • State EVV Solution interim option: If a Provider Choice System is not fully interfacing with Sandata to transmit EVV records to the Department, providers may use the State EVV Solution until the interface is complete to ensure compliance. If a Provider Choice system will not be fully interfaced with Sandata before January 1, 2021, the State EVV Solution interim option may be used to ensure no interruption in payments. Providers will not be exempt from using EVV while going through the interface process with Sandata. Providers can only use one system (either the State EVV Solution or their Provider Choice System) at a time. Providers may switch from using the State EVV Solution to the Provider Choice System when they are ready; there is no time limit for using the State EVV Solution. Providers must notify Sandata of the transition and complete all necessary training to use the State EVV Solution or Data Aggregator view for Provider Choice Systems.
      • Switching to a different EVV vendor: Providers may switch to a different EVV vendor, to the State EVV Solution, or away from the State EVV Solution at any time for any reason. Providers must notify Sandata of the transition, ensure proper interfacing, and complete all necessary training to use the State EVV Solution or Date Aggregator view for Provider Choice systems.
      • CDASS vendor switching: Each Financial Management Service (FMS) vendor is utilizing a Provider Choice System. If a CDASS member or their authorized representative, would like to utilize a different EVV system, they may change FMS vendors during quarterly open enrollment periods.

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    4. Live-in Caregivers

      The Department does not require EVV from Live-in Caregivers for many services. However, individual Provider Agencies may choose to require EVV for Live-in Caregivers.

      Live-in Caregiver Definition

      The Department has developed the following definition based on federal precedent and stakeholder engagement:

      Live-in Caregiver means a caregiver who permanently or for an extended period of time resides in the same residence as the Medicaid member receiving services. Live-in caregiver status is determined by meeting requirements established by the U.S. Department of Labor, Internal Revenue Service, or Department-approved extenuating circumstances.

      Types of Services Eligible or Ineligible for Live-in Caregiver Exemption

      Services provided by Live-in Caregivers are often delivered incrementally and without clearly defined start and end times. The Department recognizes the unique challenges of collecting EVV for this type of care and allows providers to exempt the appropriate EVV Types of Service from EVV if provided by a documented Live-in Caregiver. The EVV Types of Service that are eligible to use the Live-in Caregiver exemption are:

      EVV Type of Service Live-in Caregiver
      Behavioral Therapies Eligible
      Consumer Directed Attendant Support Services (CDASS) (and CDASS SLS Health Maintenance) Eligible
      Home Health (including CNA, Nursing, OT, PT, and ST) Eligible
      Homemaker Eligible
      Hospice (including In-Home and Inpatient) Eligible
      Independent Living Skills Training (ILST) and Life Skills Training (LST) Eligible
      In-Home Support Services (IHSS) Eligible
      Occupational Therapy Ineligible
      Pediatric Behavioral Therapies Ineligible
      Pediatric Personal Care Eligible
      Personal Care Eligible
      Physical Therapy Ineligible
      Private Duty Nursing Eligible
      Respite and Youth Day Eligible
      Speech Therapy Ineligible

      Provider Responsibilities

      Billing providers are responsible for compiling, maintaining, and validating all records justifying the status of each Live-in Caregiver for Department verification and auditing. The Live-in Caregiver Attestation Form and all supporting documentation must be collected and validated prior to utilizing the Live-in Caregiver exemption. Documentation must be valid during the time of service and billing dates if EVV is not collected. Providers should review instructions and requirements outlined in the Live-in Caregiver Attestation Form and Live-in Caregiver Memo for additional details.

      Billing providers are responsible for using correct billing methodology that designates Live-in Caregiver services by claim line. Claims adjudicated as provided by a Live-in Caregiver without required Live-in Caregiver documentation or EVV records are subject to recoupment.

      Consumer Directed Attendant Support Services (CDASS) Responsibilities

      CDASS Employers of Record (EOR) are responsible for compiling, maintaining, and validating all records justifying the status of a Live-in Caregiver for Department verification and auditing. The Live-in Caregiver Attestation Form and all supporting documentation must be completed by the EOR and collected by the Financial Management Service (FMS) Vendor prior to utilizing the Live-in Caregiver exemption. FMS vendors must maintain records designating the status of Live-in Caregivers. Documentation must be valid during the time of service and billing dates if EVV is not collected. EOR and FMS vendors should review instructions and requirements outlined in the Live-in Caregiver Attestation Form for additional details.

      FMS vendors are responsible for using correct billing methodology that designates Live-in Caregiver services by claim line. This process is described in the Live-in Caregiver Memo. Claims adjudicated as provided by a Live-in Caregiver without required Live-in Caregiver documentation or EVV records are subject to recoupment. EOR are responsible for the validation of Live-in Caregiver documentation. If information is incorrect or falsified, recoupment liability is with the EOR. If Live-in Caregiver documentation is not collected by the FMS vendor, and EVV is not submitted, liability is with the FMS vendor.

      Operational Methods of Billing for Live-in Caregiver Services

      Billing providers may submit claims including both Live-in Caregiver services and services requiring EVV records at the same time. Each claim line must appropriately indicate if the service was provided by  a Live-in Caregiver. If the same service is provided by both a Live-in Caregiver and a non-Live-in Caregiver, the units billed to each should be billed on separate claim lines and indicated correctly.

      For claims billed using the CMS 1500 billing methodology, Place of Service (POS) 99 must be designated for all lines where a Live-in Caregiver has delivered the service.

      For claims billed using the UB-04 billing methodology, Condition Code 23 must be designated on   the claim where all lines are services delivered by a Live-in Caregiver.

      Lines representing services not delivered by a Live-in Caregiver must use the appropriate Place of Service or Condition Code as outlined in Department billing manuals, which may not include Place of Service 99 or Condition Code 23. Providers who have previously used POS 99 to indicate information other than Live-in Caregiver designation are advised that this POS has been repurposed to identify services provided by Live-in Caregivers. Utilizing of POS 99 will require proof of Live-in Caregiver status.

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    5. Manual Entry Guidance

      Manual Visit Entry means an EVV record input in the Provider EVV Portal after the time of service delivery by administratively entering all Verification Points of Data.

      Providers utilizing the State EVV Solution can find information on entering a Manual Visit Entry in the Provider EVV Portal in the EVV Agency Provider Participant Training Guide on the Electronic Visit Verification State Solution Provider Information web page.

      Providers utilizing Provider Choice EVV Systems should reach out to vendors for information on entering a Manual Visit Entry. Provider Choice EVV Systems submit new data to the Department which updates  existing records. Providers utilizing a Provider Choice System can see the latest version of data in the Data Aggregator.

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    6. Minimum Necessary

      EVV records are used to verify that services have been delivered in as real-time a method as possible. EVV technologies are not prohibited from integrating into other technologies (such as service scheduling, payroll, or electronic health records), however only information required for the collection and submission of EVV records is necessary. Many EVV technology solutions have the capacity to collect much more information than is needed to collect and submit EVV records. The Department recognizes that some business practices may find this capacity useful but cautions that doing so may end up creating additional administrative burden in keeping all information correct.

      The Department only receives EVV-related data through the EVV program. If providers choose to use EVV technology for other uses, that information will not be sent to the Department through the EVV Program.

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    7. Modification Thresholds

      Electronic Visit Verification Record Modification Threshold Guidance   

      Electronic Visit Verification (EVV) helps assure the excellence of care delivery to Medicaid Members in Colorado and requires all visit verification points of data to be collected at the time and place of service. The Department of Health Care Policy and Financing (the Department) considers visit details added or modified after the time of service to be visit modifications. Manual visit entry is when the entire visit is added after the time of service. While the Department recognizes the practical need for visits to be modified, doing so should only be done as an exception to normal practice and the majority of all EVV records should remain unmodified.   

      The Centers for Medicare & Medicaid Services (CMS) has directed the Department to monitor EVV records for how many modified visits are submitted per provider and determine what an appropriate proportion of modifications is in Colorado. This appropriate proportion is referred to as a Threshold. The Department formally defines thresholds as the acceptable limit of modified and manual EVV records determined as a percent of paid claims each month.    

      After claims are paid, EVV records that have been matched to claims are reviewed in a post-payment review to determine if appropriate thresholds have been met. Modified and manually entered EVV records will not automatically stop payments and may allow claims to pay, however, exceeding thresholds persistently and intentionally could imply a need for performance improvements that may result in Department audit.   

      Provider Notes and Expectations  

      With initial implementation of the Colorado EVV Program, The Department will use data collected from billing claims from August 2020 through December 2020 to evaluate and determine thresholds for the upcoming year. Thresholds will also drive quality improvement by identifying those providers that need the Department’s involvement for re-training and quality improvement strategies.   

      The Department has specified two types of thresholds of compliance specific to the Colorado EVV program; the Modified Record Threshold and the Manual Entry Record Threshold. Differentiating between these records will allow providers and the Department to best determine root causes and develop quality improvement strategies. The thresholds established will be effective starting February 1, 2021, and billing providers will be communicated with directly as needed.   

      Provider Billing  

      Providers are advised that exceeding thresholds surrounding modified and manual entry EVV records will not automatically stop payments. After claims are paid, EVV records that have been matched to claims are reviewed in a post-payment review to determine if appropriate thresholds have been met. If the provider modifies an EVV record already matched to a paid claim, the provider is responsible for re-billing the matched claim to assure it still matches.  

      Unmodified EVV Record   

      Providers are responsible to maintain accurate service delivery records. If the provider merges multiple EVV records and no points of the visits were modified, the record will remain an Unmodified EVV Record.   

      If the provider updates EVV records indicating an alternate location and no other verification data points are modified, the record will remain an Unmodified EVV Record.  

      If the provider modifies an EVV record already matched to a paid claim, the provider is responsible for re-billing the matched claim to assure it still matches.

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    8. Telemedicine/Telehealth and EVV

      Telemedicine and Telehealth are remote delivery options for Health First Colorado services that utilize interactive audio, interactive video, or interactive data communication instead of in-person contact.

      Providers delivering services requiring EVV through Telemedicine or Telehealth are responsible for the capture and reporting of EVV to the Department, regardless whether the provider is utilizing a Provider Choice System or the State EVV Solution. Providers utilizing Telemedicine or Telehealth should refer to the EVV Types of Service – Service Code Inclusion list, available on the Electronic Visit Verification Resources web page under the Department Guidance section to determine if EVV is required.

      Many EVV-required services have expanded to include Telemedicine and Telehealth designated by a Place of Service 02 (for CMS 1500 methodology), or a Modifier GT (for UB-04 methodology). All EVV- appropriate services delivered through Telemedicine or Telehealth require EVV to be collected by the caregiver. Many EVV technologies automatically record the location of the caregiver providing services through Telemedicine or Telehealth; the location in the EVV record must indicate the location of the member receiving services through Telemedicine or Telehealth. Provider Agencies may utilize Alternate Location methodology as needed.

      Telemedicine and Telehealth are emerging fields and continue to develop in Colorado. Future guidance will be posted in Telemedicine resources, posted on the EVV website, and sent to affected providers as needed.

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    9.  Consumer Directed Attendant Support Services

Consumer Directed Attendant Support Services (CDASS) Members are required to submit Electronic Visit Verification (EVV) records and that beginning January 1, 2021 all services submitted to the Department through your Financial Management Service vendor (FMS) must have an EVV record. The Department has prepared this guidance specifically for CDASS Members to clarify what this means in practice here in Colorado.   

CDASS Members/Authorized Representatives (AR) are responsible for the following:   

  • Ensuring Attendant collection of EVV records at the time of service. The Attendant may manually enter EVV records if the record was not collected at the time of service.   
  • If an EVV record that has been submitted needs to be modified, the CDASS Member/AR is responsible for updating the record.    
  • Ensuring that EVV records precede all approved service hours submitted to the FMS vendor by the designated FMS billing deadlines. This allows billing to be compared to existing EVV records.    
  • If an issue arises from incorrect billing (for example, approving service hours without associated EVV records), then the CDASS Member/AR must update the EVV record and re-bill. FMS vendors are not responsible for the re-billing of incorrectly filed claims.   
  • EVV is only a visit record component, it does not complete the other billing requirements for attendant reimbursement. CDASS Members/ARs are required to follow all normal business, contractual, and department requirements for billing, including correct coding, timely filing, and any other Department requirements.   
  • CDASS Members/ARs are also advised to communicate and coordinate with the FMS vendor in the case of an EVV record dispute or experiencing issues.

Responsibilities of the CDASS Attendant:   

  • Collecting EVV at the time of service by utilizing the FMS EVV App and/or Telephony options.   
  • If EVV is not collected at the time of service, notifying the CDASS Member so they may add or update the EVV records as needed.    

Responsibilities of the FMS vendor:   

  • FMS vendors are responsible for having a system that submits required EVV records correctly to the Department that may be billed against by CDASS Members/ARs.   
  • All technical support questions regarding this system may be directed to the FMS vendor directly.   

In addition to the defined roles and responsibilities of using EVV for CDASS, please also be aware of the following:   

“Thresholds” refer to the proportion of manual or modified EVV entries to unmodified EVV entries.

  • Any record not collected at the time of service and then manually entered after the time of service is considered a manual entry.   
  • Any record that has been modified after the time of service is considered a modified entry.   
  • Any record that has not been modified in any way since the collection at the time of service is considered an unmodified entry.   

The appropriate proportion, or threshold limits, has not yet been determined as of November 2020 and CDASS Members/ARs are encouraged to focus on complying with the collection and submission of EVV records to bill correctly.   

At this time the Department wants to ensure that those utilizing EVV are sending the necessary records and are not focused on threshold violations.  

Thresholds will not be used to deny payments but CDASS Members/ARs with abnormally high proportions of EVV records not recorded at the time of service may be subject to corrective actions plans by the Department in the future.   

  • Technical use support of the FMS system should be referred to the FMS vendor for training and assistance.   
  • EVV does not change the nature of CDASS and all program rules for CDASS still apply with the addition for the collection of EVV for visits.  

CDASS Members/ARs are again reminded that they act as the Employer of Record and must bill the FMS vendor correctly. Specifically, Members/ARs must bill against an EVV record on file by the FMS billing deadlines. CDASS Members/ARs may update EVV records within CDASS Program rule timely filing and re-bill if needed as allowed within CDASS Program rules.   

Please refer all EVV use questions directly to your FMS vendor to expedite issue resolution.  

  1. EVV Types of Service

    Similar services are grouped into Colorado EVV Types of Service to reduce administrative burden during service delivery. Rather than having caregivers record each billing code at the time of service, only the "Type of Service" is needed. This drastically reduces the administrative burden for both caregivers working with Medicaid Members as well as provider administrators responsible for maintaining EVV records.

    Caregivers and Administrators interested in each type of service should refer to the "EVV Types of Service Summary Table" below.

    Billing providers interested in which billing codes are included in each Type of Service, as well as the specific circumstances in which they apply, should refer to the next section "EVV Types of Service Billing Conditions and Code Inclusions."

    To Inclusions List

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    1. Colorado EVV Types of Service Summary Table

      The following Types of Service are used by caregivers at the time of service and administrators maintaining EVV records:

      TVV Code Group Code Telephony Prompt for Readback Service Text Selection for Mobile
      101 CDASS Consumer Directed Attendant Support Services (CDASS) CDASS
      102 SLSHM Consumer Directed Attendant Support Services SLS Health Maintenance CDASS SLS HMA
      103 BHSVC HCBS Behavioral Services Behavioral Services
      104 HMKR Homemaker Homemaker
      105 IHSS In-Home Support Services In-Home Support Services (IHSS)
      106 PRSNL HCBS Personal Care Personal Care
      107 RSPT Respite Respite
      108 LST Skills Training ILST/LST Independent Living Skills Training (ILST) and Life Skills Training (LST)
      109 HHNUR Home Health - Nursing Home Health - Nursing
      110 HHBAS Home Health - Basic Home Health - Basic
      111 HHPT Home Health - PT Home Health - Physical Therapy
      112 HHOT Home Health - OT Home Health - Occupational Therapy
      113 HHSLT Home Health - S/LT Home Health - Speech/Language Therapy
      114 PDRN Private Duty Nursing Private Duty Nursing
      115 HSPH Hospice in Home Hospice in Home
      116 HSPIP Hospice Inpatient Hospice Inpatient
      117 PEDPC Pediatric Personal Care Pediatric Personal Care Services
      118 PEDBT Ped Behavioral Therapies Pediatric Behavioral Therapies
      119 PT Physical Therapy Physical Therapy
      120 OT Occupational Therapy Occupational Therapy
      121 SLT Speech Therapy Speech Therapy
      122 DME Durable Medical Equipment Durable Medical Equipment

       

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    2. Colorado EVV Types of Service Billing Conditions and Code Inclusions

      This section lists all billing conditions and codes included in each corresponding Colorado EVV Types of Service. All service descriptions are for reference only; if there is a difference in descriptions between this manual and reference coding books or Health First Colorado Billing Manuals located on the Billing Manual web page, providers must adhere to that advice.

      All billing codes listed in this document will require the corresponding EVV Type of Service on file as part of a verified EVV to correctly bill Health First Colorado. If a service code or condition of service delivery is not mentioned in this section, it does not require an EVV record at the time of publication. All billing codes and conditions are subject to change.

      The EVV Types of Service in Colorado below are found in this manual:

      1. Behavioral Therapies
      2. Consumer Directed Attendant Support Services (CDASS)
      3. Consumer Directed Attendant Support Services (CDASS) SLS Health Maintenance 22
      4. Home Health – Basic (Certified Nurse Aid)
      5. Home Health – Nursing
      6. Home Health - Occupational Therapy
      7. Home Health - Physical Therapy
      8. Home Health - Speech/Language Therapy
      9. Homemaker
      10. Hospice – In Home
      11. Independent Living Skills Training (ILST) and Life Skills Training (LST)
      12. In-Home Support Services (IHSS)
      13. Occupational Therapy
      14. Pediatric Behavioral Therapy
      15. Pediatric Personal Care
      16. Personal Care
      17. Physical Therapy
      18. Private Duty Nursing
      19. Respite and Youth Day
      20. Speech Therapy
    • Behavioral Therapies

      • Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations except Place of Service 11 (Office).
      • Behavioral Consultations and Behavioral Plan Assessments billed with Place of Service 11 (Office) do not require EVV.
      • All billing codes associated with EVV Type of Service "Behavioral Therapies" are:
      Procedure Modifiers Service Description
      H2019 U3     Behavioral Line Staff (Developmental Disabilities Waiver)
      H2019 U8     Behavioral Line Staff (Supported Living Services Waiver)
      H2019 U3 22 TG Behavioral Consultation (Developmental Disabilities Waiver)
      H2019 U8 22 TG Behavioral Consultation (Supported Living Services Waiver)
      H2019 U3 TF TG Behavioral Counseling (Developmental Disabilities Waiver)
      H2019 U8 TF TG Behavioral Counseling (Supported Living Services Waiver)
      H2019 U3 TF HQ Behavioral Counseling, Group (Developmental Disabilities Waiver)
      H2019 U8 TF HQ Behavioral Counseling, Group (Supported Living Services Waiver)
      T2024 U3 22   Behavioral Plan Assessment (Developmental Disabilities Waiver)
      T2024 U8 22   Behavioral Plan Assessment (Supported Living Services Waiver)

       

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      Consumer Directed Attendant Support Services (CDASS)

      • Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations.
      • All billing codes associated with EVV Type of Service "Consumer Directed Attendant Support Services (CDASS)" are:
      Procedure Modifiers Service Description
      T2025 U8   Consumer Directed Attendant Support Service - Enhanced Homemaker, Homemaker, Personal Care (Supported Living Services Waiver)
      T2025 U1   Consumer Directed Attendant Support Service - Health Maintenance, Homemaker, Personal Care (Elderly, Blind, and Disabled Waiver)
      T2025 UA   Consumer Directed Attendant Support Services - Health Maintenance, Homemaker, Personal Care (Community Mental Health Supports Waiver)
      T2025 U6   Consumer Directed Attendant Support Service - Health Maintenance, Homemaker, Personal Care (Brain Injury Waiver)
      T2025 U1 SC Consumer Directed Attendant Support Service - Health Maintenance, Homemaker, Personal Care (Spinal Cord Injury Waiver)


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      Consumer Directed Attendant Support Services (CDASS) SLS Health Maintenance

      • Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations.
      • All billing codes associated with EVV Type of Service "CDASS SLS Health Maintenance service" is:
      Procedure Modifiers Service Description
      T2025 U8 SE Consumer Directed Attendant Support Services – Health Maintenance (Supported Living Services Waiver)

       

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      Home Health – Basic (Certified Nurse Aid)

      • Used by Home Health Agencies (Billing Provider Type 10).
      • Applicable in all locations.
      • All billing codes associated with "Home Health – CNA" services are:
      Revenue Service Description
      570 Home Health Aide Basic (Acute)
      571 Home Health Aide Basic (Long-Term)
      572 Home Health Aide Extended (Acute)
      579 Home Health Aide Extended (Long-Term)

       

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      Home Health – Nursing

      • Used by Home Health Agencies (Billing Provider Type 10).
      • Applicable in all locations.
      • All billing codes associated with "Home Health – RN" services are:
      Revenue Service Description
      550 RN/LPN Standard Visit (Acute)
      551 RN/LPN Standard Visit (Long-Term)
      590 Uncomplicated Nursing (Brief Visit 1st of Day)
      599 Uncomplicated Nursing Visit (Visit 2+ of Day)

       

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      Home Health - Occupational Therapy

      • Used by Home Health Agencies (Billing Provider Type 10).
      • Applicable in all locations.
      • Occupational Therapists providing services that are billed with procedure codes instead of revenue codes through a Home Health Agency are advised to refer to the Occupational Therapy Service Type
      • All billing codes associated with "Home Health – Occupational Therapy" services are:
      Revenue Service Description
      430 Occupational Therapy (Acute)
      431 Occupational Therapy (Long-Term)
      434 Occupational Therapy for HCBS Home Mod Evaluation

       

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      Home Health - Physical Therapy

      • Used by Home Health Agencies (Billing Provider Type 10).
      • Applicable in all locations.
      • Physical Therapists providing services that are billed with procedure codes instead of revenue codes through a Home Health Agency are advised to refer to the Physical Therapy Service Type
      • All billing codes associated with "Home Health – Physical Therapy" services are:
      Revenue Service Description
      420 Physical Therapy (Acute)
      421 Physical Therapy (Long-Term)
      424 Physical Therapy for HCBS Home Mod Evaluation

       

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      Home Health - Speech/Language Therapy

      • Used by Home Health Agencies (Billing Provider Type 10).
      • Applicable in all locations.
      • Speech/Language Therapists providing services that are billed with procedure codes instead of revenue codes through a Home Health Agency are advised to refer to the Speech/Language Therapy Service Type
      • All billing codes associated with "Home Health – Speech/Language Therapy" services are:
      Revenue Service Description
      440 Speech/ Language Therapy (Acute)
      441 Speech/ Language Therapy (Long-Term)

       

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      Homemaker

      • Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations.
      • All billing codes associated with "Homemaker" services are:
      Procedure Modifiers Service Description
      S5130 U1   Homemaker (Elderly, Blind, and Disabled Waiver)
      S5130 UA   Homemaker (Community Mental Health Supports Waiver)
      S5130 U1 SC Homemaker (Spinal Cord Injury Waiver)
      S5130 U8   Homemaker - Basic (Supported Living Services Waiver)
      S5130 U7   Homemaker - Basic (Children's Extensive Supports Waiver)
      S5130 U8 22 Homemaker - Enhanced (Supported Living Services Waiver)
      S5130 U7 22 Homemaker - Enhanced (Children's Extensive Supports Waiver)

       

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      Hospice – In Home

      • Used by Hospice Agencies (Billing Provider Type 50).
      • Applicable in all locations
      • "Hospice – Inpatient" is currently not used in the Colorado EVV Program
      • All Hospice services provided "in home" do require EVV and are subject to Post Payment review, but Hospice services do not require EVV records to pay initially.
      • All billing codes associated with "Hospice - in Home" are:
      Revenue Service Description
      650 Routine Home Care (1-60 days)
      651 Routine Home Care (61+ days)
      652 Continuous Home Care/Service Intensity Add-On

       

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      Independent Living Skills Training (ILST) and Life Skills Training (LST)

      • Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations.
      • All billing codes associated with "Independent Living Skills Training (ILST) and Life Skills Training (LST)" are:
      Procedure Modifiers Service Description
      T2013 U6   Independent Living Skills Training (Brain Injury Waiver)
      H2014 UA   Life Skills Training (Community Mental Health Supports Waiver)
      H2014 U3   Life Skills Training (Developmental Disabilities Waiver)
      H2014 U1   Life Skills Training (Elderly, Blind, and Disabled Waiver)
      H2014 U1 SC Life Skills Training (Spinal Cord Injury Waiver)
      H2014 U8   Life Skills Training (Supported Living Services Waiver)

       

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      In-Home Support Services (IHSS)

      • Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations.
      • All billing codes associated with "In-Home Support Services (IHSS)" are:
      Procedure Modifiers Service Description
      H0038 U5       In-Home Support Services (IHSS) - Health

      Maintenance (Children's Home and Community Based Services Waiver)
      H0038 U1       In-Home Support Services (IHSS) - Health Maintenance (Elderly, Blind, and Disabled Waiver)
      S5130 U1 KX     In-Home Support Services (IHSS) - Homemaker (Elderly, Blind, and Disabled Waiver)
      T1019 U1 KX     In-Home Support Services (IHSS) - Personal Care (Elderly, Blind, and Disabled Waiver)
      T1019 U1 HR KX   In-Home Support Services (IHSS) - Relative Personal Care (Elderly, Blind, and Disabled Waiver)
      H0038 U1 SC     In-Home Support Services (IHSS) - Health Maintenance (Spinal Cord Injury Waiver)
      S5130 U1 SC KX   In-Home Support Services (IHSS) - Homemaker (Spinal Cord Injury Waiver)
      T1019 U1 SC KX   In-Home Support Services (IHSS) - Personal Care (Spinal Cord Injury Waiver)
      T1019 U1 SC HR KX In-Home Support Services (IHSS) - Relative Personal Care (Spinal Cord Injury Waiver)

       

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      Occupational Therapy

      • Used by Occupational Therapy providers (Billing Provider Types 16, 25, 27, and 48)
      • Applicable in Places of Service 2, 4, 12, 15, 16, 18, or 99.
      • Occupational Therapy providers are ineligible for Live-in Caregiver designation.
      • All billing codes associated with "Occupational Therapy" are:
      Procedure Service Description (Occupational Therapy)
      92526 Treatment of swallowing dysfunction and/or oral function for feeding
      96112 Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour
      96113 Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure)
      97010 Application of hot or cold packs to 1 or more areas
      97012 Application of mechanical traction to 1 or more areas
      97014 Application of electrical stimulation to 1 or more areas, unattended by physical therapist
      97016 Application of blood vessel compression or decompression device to 1 or more areas
      97018 Application of hot wax bath to 1 or more areas
      97022 Application of whirlpool therapy to 1 or more areas
      97024 Application of heat wave therapy to 1 or more areas
      97026 Application of low energy heat (infrared) to 1 or more areas
      97028 Application of ultraviolet light to 1 or more areas
      97032 Application of electrical stimulation to 1 or more areas, each 15 minutes
      97033 Application of medication through skin using electrical current, each 15 minutes
      97034 Therapeutic hot and cold baths to 1 or more areas, each 15 minutes
      97035 Application of ultrasound to 1 or more areas, each 15 minutes
      97036 Occupational therapy treatment to 1 or more areas, Hubbard tank, each 15 minutes
      97110 Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes
      97112 Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes
      97113 Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes
      97116 Walking training to 1 or more areas, each 15 minutes
      97124 Therapeutic massage to 1 or more areas, each 15 minutes
      97129 Therapeutic interventions that focus on cognitive function and compensatory strategies to manage the performance of an activity; initial 15 minutes
      97130 Therapeutic interventions that focus on cognitive function and compensatory strategies to manage the performance of an activity; each additional 15 minutes
      97140 Manual (physical) therapy techniques to 1 or more regions, each 15 minutes
      97150 Therapeutic procedures in a group setting
      97165 Evaluation of occupational therapy, low complexity typically 30 minutes
      97166 Evaluation of occupational therapy, moderate complexity typically 45 minutes
      97167 Evaluation of occupational therapy established plan of care, high complexity typically 60 minutes
      97168 Re-evaluation of occupational therapy established plan of care, typically 30 minutes
      97530 Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes
      97533 Sensory technique to enhance processing and adaptation to environmental demands, each 15 minutes
      97535 Self-care or home management training, each 15 minutes
      97537 Community or work reintegration training, each 15 minutes
      97542 Wheelchair management training, each 15 minutes
      97545 Work hardening or conditioning, first 2 hours
      97546 Work hardening or conditioning add-on
      97597 Removal of tissue from wounds per session - rmvl devital tis 20 cm/<
      97598 Removal of tissue from wounds per session - rmvl devital tis addl 20cm/<
      97602 Wound(s) care non-selective - removal of tissue from wounds per session
      97750 Physical performance test or measurement with report, each 15 minutes
      97755 Assistive technology assessment to enhance functional performance, each 15 minutes
      97760 Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk, per 15 minutes
      97761 Training in use of prosthesis for arms and/or legs, per 15 minutes
      97763 Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes
      97799 Unlisted physical medicine/rehabilitation service or procedure
      L1902 Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf
      L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
      L3730 Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated
      L3763 Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3764 Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3808 Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment
      L3900 Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated
      L3906 Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3908 Wrist hand orthosis, wrist extension control cock-up, non-molded, prefabricated, off-the-shelf
      L3912 Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf
      L3919 Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3923 Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
      L3925 Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non- torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf
      L3929 Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
      L3933 Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment
      L3982 Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment
      Q4040 Cast supplies, short leg cast, pediatric (0-10 years), fiberglass
      Q4048 Cast supplies, short leg splint, pediatric (0-10 years), fiberglass

       

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      Pediatric Behavioral Therapy

      • Used by Pediatric Behavioral Therapy providers (Billing Provider Types 16, 24, 25, 37, 38, 83, and 84)
      • Applicable in Places of Service 2, and 12.
      • Pediatric Behavioral Therapy providers are ineligible for Live-in Caregiver designation.
      • All billing codes associated with "Pediatric Behavioral Therapy" are:
      Revenue Modifier Service Description
      97153   Adaptive behavior treatment by protocol, administered by technician under direction of qualified health care professional to one patient, each 15 minutes
      97154   Adaptive behavior treatment by protocol, administered by technician under direction of qualified health care professional to multiple patients, each 15 minutes
      97155   Adaptive behavior treatment with protocol modification administered by qualified health care professional to one patient, each 15 minutes
      97158   Group adaptive behavior treatment with protocol modification administered by qualified health care professional to multiple patients, each 15 minutes
      97151   Behavior identification assessment, face-to-face with patient and caregiver(s), includes administration of standardized and non-standardized tests, detailed behavioral history, patient observation and caregiver interview, interpretation of test results, discussion of findings and recommendations with the primary guardian(s)/caregiver(s), and preparation of report.
      97151 TJ Behavior identification re-assessment, limited to 2 units per six months, each 30 minutes

       

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      Pediatric Personal Care

      • Used by Personal Care Agencies (Billing Provider Type 60)
      • Applicable in Places of Service 2, 12, and 99.
      • Personal Care provided by HCBS Providers (Billing Provider Type 36) also require EVV as well and are in the "Personal Care" section.
      • The billing code associated with "Pediatric Personal Care" is:
      Revenue Modifier Service Description
      T1019   Pediatric Personal Care Service

       

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      Personal Care

      • ​Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations.
      • Pediatric Personal Care provided by Personal Care Agencies (Billing Provider Type 60) also require EVV as well and are in the "Pediatric Personal Care" section
      • All billing codes associated with "Personal Care" are:
      Revenue Modifiers Service Description
      T1019 U1     Personal Care (Elderly, Blind, and Disabled Waiver)
      T1019 UA     Personal Care (Community Mental Health Supports Waiver)
      T1019 U6     Personal Care (Brain Injury Waiver)
      T1019 U1 SC   Personal Care (Spinal Cord Injury Waiver)
      T1019 U8     Personal Care (Supported Living Services Waiver)
      T1019 U7     Personal Care (Children's Extensive Supports Waiver)
      T1019 U1 HR   Personal Care - Relative (Elderly, Blind, and Disabled Waiver)
      T1019 UA     Personal Care - Relative (Community Mental Health Supports Waiver)
      T1019 U6 HR   Personal Care - Relative (Brain Injury Waiver)
      T1019 U1 SC HR Personal Care - Relative (Spinal Cord Injury Waiver)

       

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      Physical Therapy

      • Used by Physical Therapy providers (Billing Provider Types 16, 17, 25, and 48)
      • Applicable in Places of Service 2, 4, 12, 15, 16, 18, or 99.
      • Physical Therapy providers are ineligible for Live-in Caregiver designation.
      • All billing codes associated with "Physical Therapy" are:
      Procedure Service Description (Physical Therapy)
      90911 Biofeedback training, perineal muscles, anorectal or urethral sphincter
      96112 Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour
      96113 Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure)
      97010 Application of hot or cold packs to 1 or more areas
      97012 Application of mechanical traction to 1 or more areas
      97014 Application of electrical stimulation to 1 or more areas, unattended by physical therapist
      97016 Application of blood vessel compression or decompression device to 1 or more areas
      97018 Application of hot wax bath to 1 or more areas
      97022 Application of whirlpool therapy to 1 or more areas
      97024 Application of heat wave therapy to 1 or more areas
      97026 Application of low energy heat (infrared) to 1 or more areas
      97028 Application of ultraviolet light to 1 or more areas
      97032 Application of electrical stimulation to 1 or more areas, each 15 minutes
      97033 Application of medication through skin using electrical current, each 15 minutes
      97034 Therapeutic hot and cold baths to 1 or more areas, each 15 minutes
      97035 Application of ultrasound to 1 or more areas, each 15 minutes
      97036 Occupational therapy treatment to 1 or more areas, Hubbard tank, each 15 minutes
      97110 Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes
      97112 Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes
      97113 Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes
      97116 Walking training to 1 or more areas, each 15 minutes
      97124 Therapeutic massage to 1 or more areas, each 15 minutes
      97129 Therapeutic interventions that focus on cognitive function and compensatory strategies to manage the performance of an activity; initial 15 minutes
      97130 Therapeutic interventions that focus on cognitive function and compensatory strategies to manage the performance of an activity; each additional 15 minutes
      97140 Manual (physical) therapy techniques to 1 or more regions, each 15 minutes
      97150 Therapeutic procedures in a group setting
      97161 Evaluation of physical therapy, low complexity typically 20 minutes
      97162 Evaluation of physical therapy, moderate complexity typically 30 minutes
      97163 Evaluation of physical therapy, high complexity typically 45 minutes
      97164 Re-evaluation of physical therapy, typically 20 minutes
      97530 Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes
      97533 Sensory technique to enhance processing and adaptation to environmental demands, each 15 minutes
      97535 Self-care or home management training, each 15 minutes
      97537 Community or work reintegration training, each 15 minutes
      97542 Wheelchair management training, each 15 minutes
      97545 Work hardening or conditioning, first 2 hours
      97546 Work hardening or conditioning add-on
      97597 Removal of tissue from wounds per session - rmvl devital tis 20 cm/<
      97598 Removal of tissue from wounds per session - rmvl devital tis addl 20cm/<
      97602 Wound(s) care non-selective - removal of tissue from wounds per session
      97750 Physical performance test or measurement with report, each 15 minutes
      97755 Assistive technology assessment to enhance functional performance, each 15 minutes
      97760 Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk, per 15 minutes
      97761 Training in use of prosthesis for arms and/or legs, per 15 minutes
      97763 Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes
      97799 Unlisted physical medicine/rehabilitation service or procedure
      20560 Needle insertion(s) without injection(s); 1 or 2 muscle(s)
      20561 Needle insertion(s) without injection(s); 3 or more muscles
      L1902 Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off- the-shelf
      L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
      L3730 Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated
      L3763 Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3764 Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3808 Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment
      L3900 Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated
      L3906 Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3908 Wrist hand orthosis, wrist extension control cock-up, non-molded, prefabricated, off-the-shelf
      L3912 Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf
      L3919 Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
      L3923 Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
      L3925 Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non- torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf
      L3929 Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
      L3933 Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment
      L3982 Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment
      Q4040 Cast supplies, short leg cast, pediatric (0-10 years), fiberglass
      Q4048 Cast supplies, short leg splint, pediatric (0-10 years), fiberglass

       

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      Private Duty Nursing

      • Used by Home Health Agencies (Billing Provider Type 10).
      • Applicable in all locations.
      • All billing codes associated with "Private Duty Nursing" are:
      Procedure Service Description (Physical Therapy)
      552 Private Duty Nursing -RN
      559 Private Duty Nursing -LPN
      580 Private Duty Nursing -RN (group-per client)
      581 Private Duty Nursing - LPN (group-per client)
      582 Blended Group rate (RN/LPN)

       

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      Respite and Youth Day

      • Used by HCBS Providers (Billing Provider Type 36).
      • Applicable in all locations.
      • All billing codes associated with "Respite and Youth Day" are:
      Procedure Modifiers Service Description
      S5150 U6   Respite - In-Home (Brain Injury Waiver)
      S5150 U7   Respite - Individual (Children's Extensive Supports Waiver)
      S5151 U7   Respite - Individual, Per Diem (Children's Extensive Supports Waiver)
      S5151 U7 HQ Respite - Group (Children's Extensive Supports Waiver)
      S5150 U9 HA Individual – In Family Home (15 minutes) (Children’s Habilitation Residential Program Waiver)
      S5151 U9 HA Individual – In Family Home (Day) (Children’s Habilitation Residential Program Waiver)
      T1005 UD   Respite - CNA (4 hours or less) (Children with Life Limiting Illness Waiver)
      S9125 UD   Respite - CNA (4 hours or more) (Children with Life Limiting Illness Waiver)
      T1005 UD TD Respite - Skilled RN/LPN (4 hours or less) (Children with Life Limiting Illness Waiver)
      S9125 UD TD Respite - Skilled RN/LPN (4 hours or more) (Children with Life Limiting Illness Waiver)
      S5150 UD   Respite - Unskilled (4 hours or less) (Children with Life Limiting Illness Waiver)
      S5151 UD   Respite - Unskilled (4 hours or more) (Children with Life Limiting Illness Waiver)
      S5150 U1   Respite - In-Home (Elderly, Blind, and Disabled Waiver)
      S5151 U8 HQ Respite - Group (Supported Living Services Waiver)
      S5150 U1 SC Respite - In-Home (Spinal Cord Injury Waiver)
      S5150 U8   Respite - Individual (Supported Living Services Waiver)
      S5151 U8

       

      Respite - Individual - Day (Supported Living Services Waiver)
      T2026 U7 HQ Youth Day Services - Group (Children's Extensive Supports Waiver)
      T2027 U7   Youth Day Services - Individual (Children's Extensive Supports Waiver)

       

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      Speech Therapy

      • Used by Speech Therapy providers (Billing Provider Types 16, 25, 27, and 48)
      • Applicable in Places of Service 2, 4, 12, 15, 16, 18, or 99.
      • Speech Therapy providers are ineligible for Live-in Caregiver designation.
      • All billing codes associated with Speech Therapy are:
      Procedure Service Description (Speech Therapy)
      92521 Evaluation of speech fluency (e.g. stuttering, cluttering)
      92522 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
      92523 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)
      92524 Behavioral and qualitative analysis of voice and resonance
      92507 Treatment of speech, language, voice, communication and/or auditory disorder; individual.
      92508 Speech/hearing treatment, group, 2 or more individuals
      92520 Laryngeal function studies
      92526 treatment of swallowing and/or oral feeding function
      92597 #N/A
      92605 Evaluate for device
      92606 Non-speech device service
      92607 Evaluation for speech generating device, first hour
      92608 Additional 30 minutes of evaluation for 92607
      92609 Use of speech device service
      92610 Evaluation of oral and pharyngeal swallowing function
      92611 Motion fluoroscopic evaluation of swallowing function
      92612 Flexible fiber optic endoscopic evaluation by cine or video recording
      92614 Flexible fiber optic endoscopic laryngeal sensory testing by cine or video recording
      92626 Evaluation of auditory rehab status; first hour
      92627 Each additional 15 minutes of 92626
      96105 Assessment of aphasia, per hour
      96111 Developmental testing; extended with interpretation and report, per hour
      96112 Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour
      96113 Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure)
      97755 Assistive technology assessment to enhance functional performance, each 15 minutes
      Q3014 Telehealth originating site facility fee


 

  1. Appendix A: Alternate Location Guidance for State EVV Solution

    Correcting EVV locations after caregiver has completed visit

    All EVV records may be updated to reflect actual locations of service delivered. Providers are responsible for reporting correct EVV and billing appropriately.

    Caregiver notification (if needed) Provider Agency creates and fixes EVV record Exception
    • Report any relevant information of actual service delivery location and reasoning to Provider Agency
    • Search for the visit in "Visit Maintenance"
    • Select "Exceptions" and select "Location Required"
    • Select reason code, "Manual Entry"
    • Enter the actual location in the prompted "Reason Note" field

     

    Alternate Location using Mobile Visit Verification (MVV/mobile app)

    Though the mobile application should capture a GPS location, if service is being delivered at a location other than what is recorded, Alternate Locations may be entered.

    Caregiver notates Alternate Location from the mobile application Provider Agency fixes MVV record Exception
    • At the end of service delivery, log into MVV (the Home screen shows the visit is in progress)
    • Select "Resume Visit" (blue button)
    • Select "Add Tasks" (blue button)
    • Check "Alternate Location" (check box)
    • Select "Complete Visit" (blue button)
    • Select "Confirm" (blue button)
    • Report the actual location of service delivery and reasoning to Provider Agency.
    • "Location Required" Exception must be acknowledged in the Sandata Portal.
    • Of the reason code options, select "Location captured by MVV/TVV incorrect"
    • Enter the actual location in the prompted "Reason Note" field.

     

    Alternate Locations using Telephony Visit Verification (TVV)

    Providers may enter all known phone numbers in the Client Module of the Sandata Portal. The primary address listed will link to all entered phone numbers in the Client file when TVV is used. If calling from a known phone number but service is delivered at a location other than the client’s primary address (for example using the client’s cell phone while in the community), an Alternate Location must be notated:

    Caregiver notates Alternate Location from a known phone number Provider Agency fixes TVV record Exception
    • During the TVV call-out process, when prompted to "enter the number of tasks" - enter "1".
    • When prompted to "enter task ID", enter "1". (This notates an Alternate Location Exception to the Provider Agency.)
    • When prompted for any additional tasks, enter "0".
    • The Exception "Location Required" must be acknowledged in the Sandata Portal.
    • Of the Reason Code options prompted, select "Location captured by MVV/TVV incorrect".
    • After completing the TVV call, report the actual location of service delivery and reasoning to Provider Agency.
    • Enter the actual location of service delivery in the prompted "Reason Note" field.

     

    Caregivers may call from a phone number that is not entered in the Client Module of the Provider Portal to record EVV, however a call from an unrecognized number will be recorded as an "unknown phone number" and will trigger an Exception that must be fixed.

    Caregiver notates Alternate Location from an unknown phone number Provider Agency fixes TVV record Exception
    • Calling from a number not associated with the client automatically creates an Exception; further notation is not needed from the caregiver.
    • After completing the TVV call, report the actual location of service delivery and reasoning to Provider Agency.
    • The Exception "Unmatched Client ID/ Phone" must be acknowledged in Sandata Portal
    • Of the Reason Code options prompted, select "Location captured by MVV/TVV incorrect"
    • Enter the actual location in the prompted "Reason Note" field.

     

    Manual Visit EVV Records

    If no EVV data is recorded at the Time of Service, a Manual Visit entry may be entered. The State EVV Solution requires the location component of Manual Entries be entered as a Reason Note:

    Caregiver requests a Manual Visit EVV Provider Agency enters a Manual Visit EVV record
    • Report any relevant information of actual service delivery location and reasoning to Provider Agency
    • In the Visit Maintenance screen, select "CREATE CALL" (top right)
    • Search for and select a client (select next)
    • Search for and select an employee (select next)
    • Enter the Date, Time, and Service (select finish)
    • Find the call created in Visit Maintenance then:
      • In the Tasks tab, select the Alternate Location task
      • In the Exceptions tab, fix the "Location Required" Exception and select the "Manual Entry" reason code
      • Enter the actual location in the prompted "Reason Note" field

     

    If using the optional Scheduling Module within the State EVV Solution, a scheduled visit that has not been recorded by a caregiver at the Time of Service may be entered as a Manual Visit by adding the times of service and location:

    Caregiver requests a Manual Visit EVV for scheduled visit after completion of services

     

    Provider Agency enters a Manual Visit EVV record for a scheduled visit after caregiver has completed the service
    • Report any relevant information of actual service delivery location and reasoning to Provider Agency
    • Find the scheduled visit in Visit Maintenance
    • Select "CALL LOG"
    • Manually enter call times and select "Manual Entry" reason code when prompted

       

    • Enter the actual physical location in the prompted "Reason Note" field

     

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  2. Appendix B: EVV Live-in Caregiver Attestation

    The EVV Live-in Caregiver Attestation form is available as a fillable pdf on the Electronic Visit Verification Resources web page under the Live-in Caregiver Resources section. The Live-in Caregiver Attestation form also may be printed from the following pages and filled out manually.

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  3. Version History

    This program manual will be updated on the Electronic Visit Verification Resources web page to reflect the current state of the Colorado EVV program. As items are added or modified a short note will indicate the version and date.

    Version Released Comments
    1.1 August 2020 First release of EVV Program Manual.
    1.2 October 2020 Updates, feedback incorporation, consolidation of Colorado EVV Types of Service information, compliance timeline information incorporated
         
         

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