Electronic Visit Verification

Section 120006(a) of the 21st Century Cures Act (2016) mandates that states implement Electronic Visit Verification (EVV) for all Medicaid personal care services (PCS) and home health services (HHCS) that require an in-home visit by a provider. In Nevada, EVV is required for State plan PCS and HHCS and certain PCS-like Home and Community Based Waiver Services specific to the Frail Elderly and Physically Disabled. This applies to PCS provided under sections 1905(a)(24), 1915(c), 1915(i), 1915(j), 1915(k) and Section 1115; and HHCS provider under 1905(a)(7) of the Social Security Act or a waiver.

The Division of Health Care Financing and Policy (DHCFP), which operates Nevada’s Medicaid program, has opted for the Open Choice Model.  This is a hybrid model where the state contracts with at least one EVV vendor or operates its own EVV system while still allowing providers with existing EVV systems to continue to use those systems.  DHCFP has contracted with Sandata Technologies to operate Nevada’s EVV system.

What is EVV?

Electronic Visit Verification (EVV) uses technology to electronically record when a caregiver begins and ends in-home services with a Medicaid waiver participant. These systems require a device, such as a smartphone, GPS-enabled tablet, or landline, to collect the caregivers’ start and end times.

Sandata

Sandata LogoCareSource is working with Sandata to leverage their software platform for the EVV solution for CareSource providers in Nevada.

Who is Sandata?

Sandata supports end-to-end Electronic Visit Verification (EVV), including data aggregation and claims validation, enabling compliance with the 21st Century Cures Act.

CareSource, in partnership with Sandata, accepts billing for the following services:

  • Personal care under 21
  • Personal care over 21
  • In-home respite

Nevada Medicaid and CareSource require the use of Electronic Visit Verification (EVV) for the following procedure codes:

PDN and PCS
T1001S5180
T1002S9122
T1003S9123 (base code or TT)
T1019 (base code or TF)S9124 (base code or TT)
T1022S9470

Home Health

  • G0151
  • G0152
  • G0153
  • G0156
  • G0299
  • G0300

If you are providing any of the above Home Health Services, you need to ensure you are connected with Sandata.

Provider Types

  • P29 Home Health Care Services
  • PT30 Personal Care Services
  • PT83 Personal Care Services

To stay up to date on Nevada Medicaid alerts about EVV home health requirements, please visit EVV & PCA Enrollment.

Please visit the Sandata website for more information about EVV. Providers may also call or email Sandata for additional support.

Quick Reference Materials