Changes coming for Medicaid claims submissions for select home health care services

The Centers for Medicare & Medicaid Services (CMS) will soon require states use an Electronic Visit Verification (EVV) system to validate claim submissions for select home health care services covered under Medicaid. The State of Michigan has selected the vendor HHAeXchange to manage these claims.

How will this impact providers?

Providers will be required to submit Medicaid claims for the following services/codes to HHAeXchange, rather than directly to Priority Health. Note: This change only impacts Medicaid claims. Medicare and commercial claims won’t be affected.

Code	Service
G0151	Services performed by a qualified physical therapist in the home health or hospice setting
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting
G0153	Services performed by a qualified speech-language pathologist in the home health or hospice setting
G0156	Services of home health/hospice aide in home health or hospice settings
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting
G0300	Direct skilled nursing services of a license practical nurse (LPN) in the home health or hospice setting

When will this change go into effect?

Providers can submit impacted claims to HHAeXchange beginning September 3. Currently, the EVV effective date, at which time claims will only be accepted if submitted directly to HHAeXchange, hasn’t been determined by the state of Michigan.

How can providers prepare for this change?

We encourage home health care providers to complete onboarding through HHAeXchange to ensure an easy transition.

What’s EVV?

EVV confirms the following encounter information submitted through claims is complete and accurate:

• Date of visit
• Time of visit
• Location of visit
• Type of care or home health care service(s) provided
• Provider name
• Patient name