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DOH Issues Electronic Visit Verification Applicable Billing Codes

The Department of Health (DOH) has issued Electronic Visit Verification (EVV) billing codes for Medicaid providers of Personal Care Services (PCS) subject to federal and state EVV requirements.

The EVV PCS billing codes for Medicaid fee-for-service (FFS) and managed care (MC) are required per the federal 21st Century Cures Act. The Department is requiring that providers implement and put into use an EVV system to capture the required data points (type of service performed, individual receiving service, date of service, location of service delivery, individual providing service, and time the service begins and ends) for services billed under the codes and send them to the State’s data aggregator.

The current listing pertains only to the Consumer Directed Personal Assistance Program (CDPAP) and Children's Home and Community-Based Services (HCBS) services. We will reach out to the Department regarding whether this list will be extended to PCS delivered by licensed home care services agencies (LHCSAs). If you have questions, please contact LeadingAge NY or reach out to the Department by email at EVVHelp@health.ny.gov. More information on the EVV requirement is available here and here.

Contact: Meg Everett, meverett@leadingageny.org, 518-929-9342