Home Health providers – Electronic Visit Verification (EVV) update

Washington State Health Care Authority sent this bulletin at 01/29/2025 10:22 AM PST

January 29, 2025

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Apple Health (Medicaid) Provider Alert

Attention Home Health providers:

As of January 2025, the Health Care Authority (HCA) is removing the requirement for all home health providers to obtain an NPI as a critical condition for payment. HCA will conduct a redesign on how to submit required data elements for Home Health Electronic Visit Verification (EVV). During this redesign, HCA staff will partner with agencies, providers and MCOs to revisit developing a verification billing process that uses a more simplified claims format to reimburse home health agencies for in-home services provided to enrollees in medical assistance programs.

Health care providers will still need to comply with EVV requirements. HCA is in the process of updating the HCA website that contains EVV information to include this announcement and will make needed changes to the home health billing instructions and encounter data reporting once the new claims process is determined. Home health providers will continue to document:

Type of service performed
Individual receiving the service
Date of service
Location of service delivery
Individual providing the service
Time the service begins and ends

Since ‘go-live’ on January 1, 2024, HCA has been in a period of technical assistance. If claims have been denied due to challenges related to EVV processing altering other data elements leading to rejection and remain unpaid, please let HCA know.

HCA will provide updates as movement through this development phase occurs.

Comments or questions can be submitted to HCA via the EVV HHCS email box.

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.

Home Health providers – Electronic Visit Verification (EVV) update

Apple Health (Medicaid) Provider Alert

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About the Health Care Authority (HCA)

Disclosure notice

Nondiscrimination