Overview
Electronic Visit Verification (EVV) is an electronic system that enables providers to record and verify service delivery for Medicaid-enrolled members, ensuring accuracy, compliance, and accountability. In accordance with the 21st Century Cures Act and guidance from the Centers for Medicare & Medicaid Services (CMS), Personal Care Services (PCS) and Home Health Care Services (HHCS) provided in a home or community setting must be electronically verified. This includes services that assist with Activities of Daily Living (ADLs), whether provided alone or in combination with Instrumental Activities of Daily Living (IADLs), as well as applicable services authorized under 1915(c) Home and Community-Based Services (HCBS) waivers.
What is Electronic Visit Verification?
The Commonwealth of Kentucky has contracted with Therap to implement an EVV system. This system enables the state to confirm when a Medicaid eligible member receives services from an authorized Medicaid provider by capturing the following six required data elements:
- Date of service
- Location of service delivery
- Type of service provided
- Individual providing the service
- Individual receiving the service
- Start and end times of the service
These requirements apply to providers delivering PCS, HHCS, and certain 1915(c) HCBS waivers services. Kentucky has identified and defined specific waiver services subject to EVV requirements, including any additional services the state requires beyond the federal minimum requirements. The EVV system captures and stores service delivery data in near real time, supporting program integrity, service verification, and claims processing.
The Guiding Principles of EVV
At the Department for Medicaid Services (DMS), our approach to EVV is grounded in efficiency, quality care, and collaboration. EVV is designed to:
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Streamline documentation by simplifying processes and reducing administrative burden for members and providers
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Enhance health, safety, and well-being through accurate service tracking
- Preserve member choice by maintaining existing service levels and respecting preferred service delivery methods
- Reflect stakeholder input to ensure the system meets the needs of those it serves
- Provide training to all state sponsored system users to ensure the effective use of EVV
- Ensure compliance with federal requirements
Who Uses EVV?
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VV is used to verify services for members receiving care through certain Medicaid programs:
- Acquired Brain Injury (ABI)
- Acquired Brain Injury Long-Term Care (ABI LTC)
- Home and Community Based (HCB)
- Model II Waiver (MIIW)
- Michelle P. Waiver (MPW)
- Support for Community Living (SCL)
- Community Health for Improved Lives and Development (CHILD)
- Home Health (HH)
- Private Duty Nursing (PDN)
For Providers
Kentucky uses an open model solution, which means the provider may choose to use the state sponsored system or a third-party system. Therap is the state sponsored system.
State EVV System (Therap)
If you choose to use the state sponsored system:
- There is no cost to the provider
- The system meets federal requirements under the 21st Century Cures Act
- The system automatically transfers data to the Therap Aggregator
Third-Party EVV Systems
If you choose to use a third-party system your responsible for:
- All associated costs
- Ensuring the system meets all federal requirements under 21st Century Cures Act
- Ensuring the system integrates with the Therap Aggregator
Support