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PCS

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The office of Medical Assistance has issued an update on EVV compliance to advise providers of changes to the manual edit thresholds for Electronic Visit Verification (EVV) records in both personal care services (PCS) and home health care services (HHCS), effective with dates of service on and after January 1, 2025.

This bulletin applies to providers enrolled in the MA Program who render PCS and HHCS to beneficiaries or participants in the MA fee-for-service (FFS) delivery system, including through home and community-based services waivers and the managed care delivery system via Physical HealthChoices or Community HealthChoices. Beneficiaries may receive services in the following programs:

  • Office of Developmental Programs (ODP): Adult Autism Waiver, Community Living Waiver, Consolidated Waiver, Person/Family Directed Support Waiver, and Base Funded Program;
  • Office of Long-Term Living (OLTL): OBRA Waiver, Act 150, and Community HealthChoices; or,
  • Office of Medical Assistance Programs (OMAP): MA FFS and Physical HealthChoices.

Read the full bulletin here. This bulletin will be a key topic at the RCPA PD&A meeting on September 11, for which you can register here.

If you have any questions, please contact Fady Sahhar or Melissa Dehoff.

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Photo by Markus Winkler on Unsplash

The Medical Assistance (MA) Bulletin posted on 10-22-2021 applies to all providers that render personal care services (PCS) to beneficiaries in the fee-for-service (FFS) delivery system, including Agency with Choice and Vendor Fiscal/Employer Agent financial management services organizations that provide PCS to MA participants who are enrolled in an Office of Developmental Program or Office of Long-Term Living waiver, the Act 150 Program, or a Community HealthChoices managed care organization.

The purpose of the bulletin is to:

  • Advise providers of updates to certain error status codes (ESC) for PCS subject to electronic visit verification (EVV), effective for claims received on and after October 22, 2021; and
  • Advise providers of an updated Provider Assistance Center (PAC) contact e-mail for their use.

Providers rendering PCS in the managed care delivery system should address any questions regarding ESCs for PCS subject to EVV with the applicable managed care organization.

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