How to Navigate New Electronic Visit Verification (EVV) Rules for ABA Providers

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Electronic Visit Verification (EVV) is a way for states to validate the services people receive and to ensure that they receive the expected care. This includes the requirements of reporting the date, time, location, type of service, individual receiving the service, and individual providing the service.

Applied behavior analysis (ABA) providers must comply with Electronic Visit Verification (EVV) Rules. EVV impacts ABA providers that serve clients that receive Medicaid-reimbursed in-home services. It can be challenging to keep up with the requirements related to EVV. We’ll explore tips and strategies for helping you stay on top of this complex requirement for ABA and other behavioral health providers.

What is Electronic Visit Verification (EVV)?

EVV was a federally mandated policy implemented in the 21st Century Cures Act in 2016. EVV was developed to help ensure that home healthcare services are billed correctly. The EVV rules mandate that specific types of information be reported for services provided. Additionally, the EVV policies help ensure that fraudulent billing doesn’t occur. The services that Medicaid provides funding for must match the pre-authorized services.

Providers must be compliant with EVV regulations by January 1, 2020, for Personal Care Services (PCS) and by January 1, 2023, for Home Health Care Services (HHCS). Applied behavior analysis (ABA) services are considered Personal Care Services (PCS). It is important to look into your state’s regulations related to Electronic Visit Verification (EVV), as states may differ in their specific processes for compliance with federal EVV requirements.

State-Specific Processes for EVV Rules

To be compliant with federal EVV rules for providing ABA services for individuals with Medicaid, you must maintain appropriate records. These records will then be submitted to your state’s Medicaid EVV department. The process for Electronic Visit Verification can vary from state to state. Some states allow service providers to submit the required information through a third-party system such as practice management software. On the other hand, some states require that the information is submitted via a specific system. Review your state’s EVV requirements.

Open or Closed Model for EVV

More specifically, states can either use an open model or a closed model to meet the federal EVV requirements. In an open model, providers can use an open vendor, either a state-sponsored vendor or another EVV system, at their own expense (such as a practice management software that complies with EVV regulations). Additionally, in an open model, providers can choose their vendor and must be responsible for the cost of the vendor.

In a closed model, service providers must use a state-sponsored vendor. The state creates and manages the system that all providers (including ABA providers) must use to submit the required EVV data. Managed Care Organizations (MCOs) select a vendor for their agencies.

Finding an effective and reliable system to help you comply with EVV rules is essential to providing quality services and obtaining Medicaid reimbursement for those services.

Data required by Electronic Visit Verification (EVV)

There is specific information that is required to be compliant with EVV rules. This includes six types of data. The data that ABA providers (and all providers) must collect and report regarding their services includes:

  1. Type of service performed (specific with billing code)
  2. Individual receiving the service (full name and signature)
  3. Date the service was provided (the service or visit date)
  4. Location the service occurred
  5. Individual providing the service (full name and signature)
  6. Time the service begins and time the service ends

WebABA for EVV Compliance

Using WebABA as practice management software can be a key factor in helping ABA providers to comply with EVV (Electronic Visit Verification) rules. WebABA helps ABA providers stay organized and maintain the proper documentation necessary for managing their practices including staying compliant with government regulations and policies related to providing ethical and quality services. With WebABA, you will be able to collect all of the above-listed data that is required for EVV rules. WebABA gives you a streamlined system for ensuring that accurate information is gathered about the services provided and that this information aligns with the authorized services.


Get a free trial of WebABA today!


How to Navigate New Electronic Visit Verification (EVV) Rules

Keeping up with the requirements surrounding Electronic Visit Verification (EVV) can be challenging. To manage this complex task of providing ABA services, develop an organized and reliable system for collecting EVV data. When ABA practices have a system that has checks and balances and reduces the possibility of error, they are more likely to be compliant and have fewer setbacks regarding EVV rules and regulations.

One of the most helpful strategies is using practice management software like WebABA. Additionally, Therapy Brands is another resource for supporting billing and documentation. With these resources, your ABA organization can comply with EVV rules. Work tasks will also be easier for your ABA providers to complete as gathering the required data will be more streamlined and easier to manage.

Learn More About Electronic Visit Verification (EVV) Rules

To learn even more about navigating Electronic Visit Verification (EVV) rules, listen to the Think: Therapy podcast episode about EVV.

In this episode, host Maria Perrin interviews guest Emmet O’Gara, a healthcare veteran with over 30 years of experience in healthcare technology and leadership. He is the CEO of Sandata, an organization that develops software and services that support home care agencies in receiving reimbursement from payers and compliant with related regulations, such as EVV. Electronic Visit Verification Rules can be challenging to navigate. However, with the necessary training to comply with EVV requirements and putting effective systems in place, such as using a practice management software like WebABA, managing EVV requirements can become much easier.

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