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Utah Admin. Code R414-522-3 - Electronic Visit Verification Requirements

UtahregulationUtah Department of Health and Human Services, Division of Integrated Healthcare (Utah Medicaid)

What this rule requires your agency to do

  • 1The provider must submit EVV records to accompany each PCS or HHCS claim within three months of submitting the claim, or be subject to recoupment/penalties. (Utah Admin. Code R414-522-3; Utah Medicaid EVV guidance)(Utah Admin. Code R414-522-3; Utah Medicaid EVV guidance)
  • 2The provider must ensure each EVV record captures the date of the service, the location of service delivery, and the individual providing the service. (Utah Admin. Code R414-522-3)(Utah Admin. Code R414-522-3)
  • 3The provider must select an EVV service vendor whose system complies with the 21st Century Cures Act, HIPAA, and the HITECH Act, and must make EVV records available to Medicaid for review. (Utah Admin. Code R414-522-3)(Utah Admin. Code R414-522-3)
  • 4The provider must ensure each EVV record captures the time the service begins and ends and the date of creation of the electronic record. (Utah Admin. Code R414-522-3)(Utah Admin. Code R414-522-3)
  • 5The provider must create and maintain an EVV record for all Medicaid personal care services (PCS), effective July 1, 2021, and for home health care services (HHCS), effective January 1, 2023. (Utah Admin. Code R414-522-3)(Utah Admin. Code R414-522-3)
  • 6The provider must ensure each EVV record captures the type of service performed and the individual receiving the service. (Utah Admin. Code R414-522-3)(Utah Admin. Code R414-522-3)

Applies to: personal care services / home health services

Utah requires an EVV record for all Medicaid personal care services (effective July 1, 2021) and home health care services (effective January 1, 2023). The rule implements section 12006 of the 21st Century Cures Act, specifies seven mandatory data elements each EVV visit must capture, lets providers choose their own compliant EVV vendor, and requires records to accompany claims within three months, with recoupment/penalties for missing EVV data.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.