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.

Billing information

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

Service

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 Starts January 2021 after waiver renewal; currently S5130.
S5126: Supportive Home Care per day n/a Yes Starts January 2021 after waiver renewal; currently S5131.

Training

MCOs and HMOs

MCOs and HMOs will be required to complete Sandata's aggregator training. This will be a short on-demand web-based training through Sandata's learning management system. MCOs and HMOs may also attend the provider agency training for a front-to-back understanding of the DHS EVV system, but it is not required.

Provider agencies

DHS will provide free train-the-trainer sessions and resources on the DHS EVV system to provider agency administrators across all delivery systems. Administrators from Family Care FEAs, IRIS FEAs, and IRIS consultant agencies (ICAs) will also need this training.

Provider agencies will be responsible for training their workers with the DHS-provided resources and on-demand training links. Family Care FEAs, IRIS FEAs, and IRIS ICAs will be responsible for training self-directed and participant-hired workers.  

Technical specifications

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

Additional information

Last Revised: August 28, 2020