Provider Alert! Misuse of EVV Reason Codes Requirements Removed

Date: October 1, 2021

Attention: Financial Management Services Agencies and Consumer Directed Services employers

Effective Date: September 1, 2021

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: The Health and Human Services Commission (HHSC) removed the Misuse of EVV Reason Codes Requirements from the EVV Reason Code and EVV Compliance Reviews policies for dates of services on and after September 1, 2020.
How this impacts providers: Program providers, Financial Management Services Agencies and Consumer Directed Services employers are no longer required to document free text describing:

• The reason for using the same EVV Reason Code Number
• EVV Reason Code Description for the same member more than 14 days in a calendar month in the EVV system

HHSC and managed care organizations will not conduct EVV compliance reviews for misuse of reason codes. HHSC and TCHP will:

• Continue to conduct EVV-Required Free Text reviews For State-Required Personal Care Services who were required to use EVV in 2016 or earlier.
• Begin conducting EVV-Required Free Text reviews effective January 1, 2022 for Cures Act Personal Care Services required to use EVV by January 1, 2021.

Next steps for providers: When completing visit maintenance in the EVV system, program providers, FMSAs and CDS employers must continue to:

• Select the most appropriate:
  • EVV Reason Code Number
  • EVV Reason Code Description
• Enter any required free text

If you have any questions, please email TCHP’s EVV Workgroup at evvgroup@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.