Electronic Visit Verification (EVV) is a system that home-based service providers are required to use by AHCCCS in pursuant to the 21st Century Cures Act. This will eliminate all paper timesheets across the state and help prevent fraud, waste, and abuse.
The following provider types are required to use an EVV system when using a code subject to EVV:
| Provider Description | Provider Type |
| Attendant Care Agency | 40 |
| Behavioral Outpatient Clinic | 77 |
| Community Service Agency | A3 |
| Fiscal Intermediary | F1 |
| Habilitation Provider | 39 |
| Home Health Agency | 23 |
| Integrated Clinic | IC |
| Non-Medicare Certified Home Health Agency | 95 |
| Private Nurse | 46 |
You only need to utilize the EVV system you have in place while billing these codes:
| Service | HCPCS Service Code | Service | HCPCS Service Code |
| Attendant Care | S5125 | Respiratory Therapy | S5181 |
| Companion Care | S5135 | Speech Therapy | G0153/S9128 |
| Habilitation | T2017 | Private Duty Nursing | S9123/S9124 |
| Nursing | G2099/G0300 | Homemaker | S5130 |
| Home Health Aid | T1021 | Personal Care | T1019 |
| Physical Therapy | G0151/S9131 | Respite | S5150/S5151 |
| Occupational Therapy | G0152/S0120 | Skills Training and Dev | H2014 |
EVV applies to specific when billing for places of services that include:
| Places of Service Description | POS Code |
| Home | 12 |
| Assisted Living Facility | 13 |
| Other | 99 |
Sandata is the state solution for EVV. Providers can choose to utilize Sandata or hire another vendor who meets the qualifications and has completed testing through Sandata. The AHCCCS website has several options of vendors listed who have already passed testing with Sandata.
If you sign up with Sandata, you must complete their administration training. More than one person can take the training, but the provider must submit a main contact name/e-mail, which must match one of the people at your agency who has completed the administration training. You will also need to claim your welcome packet with Sandata.
Resources for Sandata contacts, trainings, and link to the AHCCCS page are found below in EVV Resources.
Please utilize the AHCCCS form templates below; providers subject to Electronic Visit Verification are required to use the forms.
Services requiring a prior authorization from the health plan will need to be entered before the services take place. This will allow the provider to enter the member’s schedule and the direct care worker will be able to clock in/out during the scheduled time.
If no prior authorization is needed from the health plan, the provider is required to enter one using the AHCCCS Service Confirmation Portal. This process will create an “authorization” that will allow a schedule to be entered and the direct care worker to clock in/out.
In hard edit mode, claims submitted for services subject to EVV, will be denied if the EVV process is not followed. All qualifying claims are reviewed by Sandata’s system to determine if EVV criteria is met. The authorization, schedule, direct care worker’s clock in/outs will all provide data for the claims validation process.
The most common claim denial reasons are:
Sandata Customer Service
AHCCCS EVV
AHCCCS Service Confirmation Portal
Admin Training to use Sandata as an EVV vendor: