EVV – When Is Respite Not Required to be EVV Compliant?

October 02, 2019

The “NOTE” below was in the Medicaid Memo on EVV published on August 21, 2019 – it was left out of the more recent memo which has caused no end of confusion!

“NOTE: EVV will not be required for services in Department of Behavioral Health and Developmental Services (DBHDS) licensed facilities, such as a group home, sponsored residential home, supervised living, supported living or similar licensed facility, the REACH Program, or in a school setting. These agency providers must use a modifier of UB in association with the agency directed service procedure code when submitting their claim.”

We have tested the “UB” modifier to the Respite billing code (T1005) and it was successful. Providers who provide respite in one of the settings licensed by DBHDS and described above should begin using the UB modifier on claims for services provided after 1 October, 2019.   Using the modifier should prevent any confusion about whether the services should have been provided under EVV!