Electronic Visit Verification (EVV) Update – Place of Service Usage Guidelines  

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Electronic Visit Verification (EVV) Update – Place of Service Usage Guidelines  

Personal Care Services (PCS) claims are included or excluded from Electronic Visit Verification (EVV) record requirements based on the Place of Service (POS) code and EVV service codes that are submitted on the CMS 1500 claim form.  

Claims for services delivered in the following locations are subject to EVV and require a verified EVV visit record:    

  • POS 04:   Homeless Shelter 
    • Use this POS for EVV-related services provided in a homeless shelter. The services MUST be provided in the shelter to use this POS. If the MaineCare member is staying in a shelter but they receive the service in the community, providers should use POS 99 as noted below. 
  • POS 12:  Home  
    • Use this POS for EVV-related services provided in the home. 
    • Provider type 86 (Section 28 providers) should use this POS for EVV-related services when the service is provided one-on-one in the members home AND when the service includes the delivery of skill building/personal care services to the member. 
  • POS 16:   Temporary Lodging 
    • Use this POS for EVV-related services provided in locations that are not the member’s permanent residence (e.g. motels, hotels, etc.).                                      

Claims for services delivered in the following locations are not subject to EVV and do not require a verified EVV visit record: 

  • POS 02: Telehealth
    • Use this POS for Home Support-Remote Support: Monitor Only and Interactive services (including MaineCare policy Sections 18, 19, 20, 21, and 29).
    • Please refer to our additional telehealth billing guidance for PCS.
  • POS 03: School
    • Use this POS when the service is delivered in a school setting.
  • POS 10: Unassigned (State EVV)
    • Use this POS for:
      • Section 28 services when the service is not delivered one-to-one within the member’s home.
      • Section 28 services when the service does not include personal care/skill-building components (e.g. one-to-one for development or completion of a comprehensive assessment).
      • Sections 12, 18, 19, 20, 21, 29, and 96 services when the individual providing the service is a live-in caregiver.

Please refer to our additional guidance on POS 10.                                                  

In most instances, providers should not deliver PCS in the following locations: 

  • 01 - Pharmacy    
  • 11 – Office        
  • 13 – Assisted Living Facility*  
  • 14 – Group Home                                     
  • 53 – Community Mental Health Center
  • 99 – Other Place of Service

*This may be an appropriate POS for section 96 services for members eligible for Private Duty Nursing, level 9. 

Please contact your Provider Relations Specialist if you have any questions about appropriate billing or about allowable service locations.