Electronic Visit Verification (EVV): Information for Program Payers

Wisconsin's EVV solution

The Wisconsin Department of Health Services (DHS) selected an EVV system for use within all DHS programs and impacted provider agencies, HMOs, MCOs, Family Care fiscal employer agents (FEAs), and IRIS FEAs. This eliminates the need for individual organizations to purchase an EVV solution. Organizations interested in using an alternate EVV system may use it as long as it meets DHS business and technical requirements.

Training

MCOs, HMOs, and IRIS FEAs

DHS provided aggregator training to program payer administrative staff. The goal is for these staff to become familiar with the aggregator tool that collects the data from their contracted providers.

MCOs and HMOs may also view the provider agency training for a front-to-back understanding of the DHS EVV system, but it is not required. 

Provider agencies

DHS provides free train-the-trainer resources on the DHS EVV system to provider agency administrators across all delivery systems. Administrators from Family Care FEAs and IRIS FEAs also need this training. More information can be found on the EVV Training webpage

Technical specifications

Following are the presentations and file specifications for the program payer Authorization and Visit File interfaces: 

Billing information

EVV visit data needs to be collected for care provided under the following service codes: 

Service or Modifier

Medicaid and BadgerCare Plus fee-for-service and BadgerCare Plus and Medicaid SSI HMOs

Family Care and Family Care Partnership IRIS
T1019: Personal Care Services per 15 minutes Yes Yes Yes
T1020: Personal Care Services per day  n/a Yes n/a
S5125: Supportive Home Care per 15 minutes n/a Yes Yes
S5126: Supportive Home Care per day n/a Yes Yes
KX Modifier: identifies a live-in worker not required to collect EVV data Yes Yes Yes
Last Revised: August 26, 2021