NY Medicaid Electronic Visit Verification (EVV)

Provider and Fiscal Intermediary Information

Providers, fiscal intermediaries, and agencies should review the following documents and procedures to remain compliant with EVV requirements.

The NYS Electronic Visit Verification (EVV) Program does not impact how Medicaid-funded Personal Care Services (PCS) are determined or delivered, only how EVV applicable services are captured. Any questions regarding the Medicaid program, service determination, service or hour utilization, service documentation or staffing concerns, should be directed to the appropriate NYS agency. For providers and fiscal intermediaries (FIs), please contact NYSDOH or OPWDD. For beneficiaries and family members, please contact your Local Department for Social Services (LDSS) or managed care plan for further assistance.

Applicable Billing Codes

Below is the list of applicable PCS billing codes for Fee-for-Service (FFS) and Managed Care (MC) Medicaid that are subject to EVV requirements. If you service any of the following billing codes, you are required to participate in EVV and send EVV data to the New York State data aggregator.

NYSDOH will post a list of applicable HHCS billing codes prior to the January 1, 2023 implementation of EVV for HHCS.

Enrollment

All providers, fiscal intermediaries, and agencies who are subject to EVV must enroll with eMedNY as a Medicaid provider, register on the eMedNY Provider Portal, and log in to the API Gateway for keys and testing. Attestation

All providers and fiscal intermediaries who are subject to EVV must also submit an annual attestation acknowledging that they do and will comply with all Cures Act, EVV, and NYS requirements, including caregiver and submitter training. The Attestation Form can be found on eMedNY.

Inquiries can be sent to EVVHelp@health.ny.gov.

EVV Program Guidelines and Requirements

The EVV Program Guidelines and Requirements document provides an overview of New York´s EVV program, providers that are subject to EVV, program and policy requirements, technical system requirements, and steps on how to begin working with NYSDOH.

Additional guidance on selecting an EVV system is also available.

Interface Control Document (ICD)

The Interface Control Document (ICD) describes the relationship between the eMedNY information system and EVV submitters and specifies the requirements of both participating systems. This includes the concept of operations, the file structure and protocols that govern the interchange of data, and the communication paths along which the data is expected to flow.

Technical User Guide

The Technical User Guide provides instructions for reporting EVV data and working with New York´s data aggregator.