What is EVV?
EVV uses technology to make sure that members and participants receive the in-home services they need. Workers check in at the beginning and check out at the end of each visit, using a mobile phone or tablet, small digital device, or landline telephone. The EVV system captures six key pieces of information:
- Who receives the service
- Who provides the service
- What service is provided
- Where the service is provided
- The date of service
- The time the service begins and ends
Workers are required to use an EVV system when providing personal care and supportive home care service (service codes T1019, T1020, S5125, S5126). These services are provided in the following programs:
- Medicaid and BadgerCare Plus fee-for-service (ForwardHealth card)
- BadgerCare Plus and Medicaid SSI HMOs
- Family Care and Family Care Partnership
- IRIS (Include, Respect, I Self-Direct)
EVV systems are secure and compliant with the Health Insurance Portability and Accountability Act (HIPAA).
Stay up to date
Join Key Conversations—an informal, monthly drop-in session. DHS staff and EVV specialists will be available to answer questions about EVV.
Getting started with EVV
Watch a video
You can start by watching our video that explains how EVV works during a visit.
Read the step-by-step guide
Next, if you’re a provider agency preparing to use an EVV system, review the New to EVV? guide. It’s available in English, Hmong, and Spanish. Provider agencies can opt for either the DHS-provided EVV system, Sandata, or an alternate EVV system.
If you’re a member, IRIS participant, or payer, choose an option from the menu on the left side of the screen to find EVV information just for you.
EVV for home health care services
The federal 21st Century Cures Act requires states to implement EVV for Medicaid-covered home health care services (HHCS) by January 1, 2023. Federal statute allows a one-year extension if the state has made a good-faith effort to comply. The Wisconsin Department of Health Services (DHS) received the extension and therefore will implement EVV for HHCS by January 1, 2024.
Proposed home health care service codes that will require use of an EVV system in Wisconsin include 92507, 97139, 97799, 99504, 99600, S9123, S9124, T1001, T1021, and T1502. Personal care service code 99509 will also require the use of an EVV system at that time.
Home health care providers do not need to do anything or purchase anything to be in compliance with the EVV requirement at this time.
Please join our email list to receive updates about EVV as they become available.
For EVV policy, refer to the Electronic Visit Verification section of the ForwardHealth Online Handbook, IRIS EVV Policy, or your HMO or MCO.
DHS will work to:
- Maintain services provided, including community integration.
- Support provider selection.
- Keep an individual’s choice of a worker.
- Ensure needed care is delivered.
- Ensure data is secure and compliant with the Health Insurance Portability and Accountability Act (HIPAA).
The 21st Century Cures Act is a federal law that was passed in 2016. It requires each state, including Wisconsin, to collect visit information using an electronic visit verification (EVV) system. The law helps make sure that members and participants receive the in-home services they need. If the Wisconsin Department of Health Services (DHS) doesn’t follow this law, Wisconsin will lose money for Medicaid services.
The chart below lists outages meeting the DHS outage policy criteria. To review the outage policy criteria and instructions on how to ensure claims are paid during an outage, providers should refer to the following:
|Date(s) of Outage||Sandata Systems Impacted||Who Does Not Need to Capture EVV During the Timeframe Listed|
|Friday, July 21, 2023 – Sunday, July 23, 2023||Sandata visit capture methods (SMC app, TVV, FVV), Sandata aggregator, Sandata EVV provider portal||All providers regardless of the system being used|
This list does not include regional power outages, temporary Sandata outages (less than 24 hours), individual provider outages, or alternate EVV vendor outages. Providers can reach out to their local utility company or consult a publicly available database for documentation of power outages. Providers using alternate EVV should contact their alternate EVV system vendor for proof of outages.
Contact Wisconsin EVV Customer Care with questions at 833-931-2035 Monday–Friday 7 a.m.–6 p.m. or at [email protected].