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Idaho Admin. Code r. 16.03.10.041 - Specialized Reimbursement: Electronic Visit Verification (EVV)

IdahoregulationIdaho Department of Health and Welfare, Division of Medicaid· effective 2022-03-17

What this rule requires your agency to do

  • 1The provider must capture and submit the six validated EVV data elements: date of service, times of service, identity of the service provider, identity of the participant, type of billable service, and location of service delivery. (IDAPA 16.03.10.041)(Idaho Admin. Code r. 16.03.10.041 - Specialized Reimbursement: Electronic Visit Verification (EVV))
  • 2The provider must submit claims for Personal Care Services, Private Duty Nursing, and covered Aged and Disabled Waiver services (Attendant Care, Homemaker, Respite) using a compliant electronic visit verification system, as mandated by Section 12006 of the 21st Century Cures Act. (IDAPA 16.03.10.041.01)(Idaho Admin. Code r. 16.03.10.041 - Specialized Reimbursement: Electronic Visit Verification (EVV))
  • 3The provider must submit EVV data to the state aggregator before submitting the corresponding billing claim. (IDAPA 16.03.10.041)(Idaho Admin. Code r. 16.03.10.041 - Specialized Reimbursement: Electronic Visit Verification (EVV))
  • 4The provider must document each participant's consent to electronic verification of service delivery. (IDAPA 16.03.10.041)(Idaho Admin. Code r. 16.03.10.041 - Specialized Reimbursement: Electronic Visit Verification (EVV))
  • 5The provider must maintain a department-certified EVV system that electronically captures information verifying service delivery. (IDAPA 16.03.10.041)(Idaho Admin. Code r. 16.03.10.041 - Specialized Reimbursement: Electronic Visit Verification (EVV))
  • 6The provider must develop policies addressing EVV implementation and the protection of participant privacy. (IDAPA 16.03.10.041)(Idaho Admin. Code r. 16.03.10.041 - Specialized Reimbursement: Electronic Visit Verification (EVV))

Applies to: home care / personal care / HCBS

Idaho requires Medicaid providers of Personal Care Services, Private Duty Nursing, and select Aged and Disabled Waiver services (Attendant Care, Homemaker, Respite) to capture and submit electronic visit verification data through a department-certified EVV system to the state aggregator before billing, in accordance with the 21st Century Cures Act.

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