A hard launch of additional Electronic Visit Verification service codes will take place on October 1, 2024. Per ForwardHealth, for Dates of Service (DOS) beginning that day, the Wisconsin Department of Health Services (DHS), along with HMOs and managed care organizations will reject home health care service codes and claims using service code 99509 that don’t include mandatory EVV information.
There are several service Electronic Visit Verification service codes that will require EVV information, including:
- Nurse supervisory personal care services
- Service Code – 99509: Home visit support for daily living and activities
- Home health care service codes:
- 92507: Individual speech, language, voice, communication, and/or auditory processing disorder support
- 97139: Unlisted therapeutic procedure (Occupational therapy)
- 97799: Unlisted physical medicine/rehabilitation (Physical Therapy)
- 99504: Home visit support
- 99600: Unlisted home visit support
- S9123: In-home nursing care from a registered nurse
- S9124: In-home nursing care from a licensed practical nurse
- T1001: Nursing evaluation
- T1021: Home health aide or certified nursing assistant
- T1502 Oral, Intramuscular and/or subcutaneous medication distribution from a health care agency
For a complete list of Electronic Visit Verification service codes, visit the EVV Resources page and click on the “Do I need to use EVV?” section.
At the beginning of the year, the Wisconsin DHS initiated soft launch of EVV for home health care services (HHCS) and service code 99509. The soft launch allows providers administrators, and direct care professionals to gain experience using Electronic Visit Verification before claims missing required EVV information are denied after October 1, 2024. During the soft launch, direct care professionals are still required to use EVV but payers will accept claims without correct EVV information.
The DHS wants to ensure visits requiring Electronic Visit Verification are submitted without errors. Direct Care professionals employed by LKiChoice participants can check their visit status in the Sandata aggregator. Through this system, only visits that have been verified will be sent to the DHS.
For more information, read more about the EVV service code hard launch from ForwardHealth Update.