South Dakota Medicaid Billing and Policy Manual — Electronic Visit Verification (EVV)

What this rule requires your agency to do

• 1The provider must capture EVV data even when the caregiver providing the service and the beneficiary live together. (SD Medicaid Billing and Policy Manual — EVV, Applicability)(SD Medicaid Billing and Policy Manual — EVV, Applicability)
• 2The provider must electronically capture six data elements for each service visit: the type of service performed, the individual receiving the service, the date of service, the location of service delivery, the individual providing the service, and the time the service begins and ends. (SD Medicaid Billing and Policy Manual — EVV, Required Data Elements)(SD Medicaid Billing and Policy Manual — EVV, Required Data Elements)
• 3The provider of Home Health services must use the designated Aggregator for the collection and submission of EVV data to the Medicaid Management Information System. (SD Medicaid Billing and Policy Manual — EVV, Aggregator)(SD Medicaid Billing and Policy Manual — EVV, Aggregator)
• 4The provider must submit each date of service and each procedure code on an individual claim line and must not bill span dates for EVV-subject services. (SD Medicaid Billing and Policy Manual — EVV, Billing)(SD Medicaid Billing and Policy Manual — EVV, Billing)
• 5The provider must apply EVV requirements to covered State Plan Personal Care and HCBS waiver services (HOPE, ADLS, Family Support 360) beginning January 1, 2021, and to Home Health and Private Duty Nursing services beginning January 1, 2024. (SD Medicaid Billing and Policy Manual — EVV, Programs/Services Covered)(SD Medicaid Billing and Policy Manual — EVV, Programs/Services Covered)
• 6The provider must limit manual entry of EVV visit data to no more than 25 percent of services, using it only as a last resort rather than an approved electronic capture method (mobile GPS application or web check-in). (SD Medicaid Billing and Policy Manual — EVV, Data Collection Methods)(SD Medicaid Billing and Policy Manual — EVV, Data Collection Methods)