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As discussed in the Medicaid Memo dated June 11, 2020, DMAS will require Electronic Visit Verification (EVV) for individuals receiving personal care, respite care, and companion services on September 1, 2020.  The Department of Medical Assistance Services (DMAS) launched EVV on October 1, 2019.  DMAS provided a transition period through August 31, 2020, for agency-directed services provided through fee for service, Commonwealth Coordinated Care Plus (CCC Plus), and Medallion 4.0 managed care plans.  Consumer-directed service EVV requirements remain unchanged.

Until August 31, 2020, DMAS will pay EVV claims, but provide error codes on EVV reporting requirements that do not fully comply.  On September 1, 2020, claims with error codes will be denied payment.  Please ensure your EVV system meets the claim requirements.

If the EVV service is provided in a Department of Behavioral Health and Developmental Services (DBHDS) licensed facilities, such as a group home, sponsored residential home, supervised living, supported living or similar licensed facility, the REACH Program, or in a school setting where the personal care is rendered under the authority of an Individualized Education Program (IEP).  The Commonwealth Coordinated Care Plus Waiver Manual, Chapter V, page 3, or the EPSDT (Personal Care Services) Supplement B, page 23, provides information on how to bill claims provided in these settings.  Providers MUST use a modifier of UB in association with the agency directed service procedure code when the service is provided in an exempt setting.  The modifier will exempt the claim from the additional reporting requirements.

Additional information on EVV is available at the following link:  http://www.dmas.virginia.gov/#/longtermprograms.  Please email EVV@dmas.virginia.gov with any questions.