Electronic Visit Verification
The 21st Century Cures Act directs state Medicaid programs to require providers of personal care services and home health services to use an electronic visit verification (EVV) system to document services rendered. Federal law requires that providers use the EVV system to document the following information:
- Date of service
- Location of service
- Individual providing service
- Type of service
- Individual receiving service
- Time the service begins and ends
With Phase One of the EVV claims processing changes fast approaching, the Ohio Department of Medicaid (ODM) is announcing dates of the following six phases of the claims adjudication process.
Provider types and list of the specific services that fall into each phase below can be found here.
| Ohio Department of Medicaid: EVV Claims Adjudication Phases | ||||||
|---|---|---|---|---|---|---|
| Phase 1 March 1, 2025 | Phase 2 June 1, 2025 | Phase 3 June 1, 2025 | Phase 4 August 1, 2025 | Phase 5 October 1, 2025 | Phase 6 January 1, 2026 | Phase 7 March 1, 2026 |
| Billed to ODM FFS | Billed to Next Gen MCEs | Billed to DODD | Billed to ODM or ODA | Billed to MyCare | ||
| Home Health Services | Private Duty Nursing, Nurse Assessment and Consult | Home Health Services | Private Duty Nursing Nurse Assessment and Consult | IO, Level 1, Self Waiver Program Services | Ohio Home Care, Passport Waiver Services | Home Health PDN, Nurse Assessment and Consult, Waiver Services |
| *Based on claim line date of service | ||||||
What is EVV?
EVV uses technology to electronically record when a caregiver begins and ends an in-home service with a Medicaid waiver participant. These systems require a device, such as a smartphone, GPS-enabled tablet, or landline, to collect the caregivers’ start and end times.
The first phase, which includes home health services claims billed to ODM, will officially go into effect on March 1, 2025. At the time of this change, claims that require EVV must have a matching EVV visit record. Claims that do not match will be denied.
Other providers will be phased in beginning on June 1, 2025, with full implementation expected by the end of the first quarter of 2026. Services and execution dates are listed in the chart.
Questions?
ODM is working with Sandata, our EVV vendor, to make sure providers are ready for this change. Look for more communication about training sessions and resources from ODM as the phases progress. Refer to the ODM EVV webpage for additional details.