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12VAC30-60-65. Electronic visit verification.

Virginiaprimary-regulationVirginia Department of Medical Assistance Services (DMAS)· effective 2021-08-18

What this rule requires your agency to do

  • 1The EVV system shall capture and retain the type of service, the individual receiving service, the date, the time service begins and ends, the location of service delivery at beginning and end (without restricting where services may be received), and the attendant or aide who provides the service (12VAC30-60-65.D.1).(12VAC30-60-65. Electronic visit verification.)
  • 2EVV data shall be submitted to DMAS with the provider's billing claim in a manner conforming to agency specifications (12VAC30-60-65.E).(12VAC30-60-65. Electronic visit verification.)
  • 3Providers shall retain EVV data for at least six years from the last date of service (records of minors retained at least six years after the minor turns 18); records retained until any audit initiated within that period is completed (12VAC30-60-65.F.2-3).(12VAC30-60-65. Electronic visit verification.)
  • 4Where a verification option is unavailable in the individual's home and delayed data input is used, the provider shall keep on file documentation of the reason the aide/attendant did not use EVV for the service delivered (12VAC30-60-65.F.5).(12VAC30-60-65. Electronic visit verification.)
  • 5Start or end times may be modified only by someone with the provider's authority (a supervisor/owner/designee for agency-directed; the fiscal employer agent for consumer-directed); workers shall not adjust a peer worker's reported time (12VAC30-60-65.D.2).(12VAC30-60-65. Electronic visit verification.)
  • 6EVV systems shall be ADA and HIPAA compliant, accessible 24/7, provide data backups, and be capable of handling multiple shifts, multiple aides/individuals, and concurrent same-location services documented separately (12VAC30-60-65.D.3-7).(12VAC30-60-65. Electronic visit verification.)
  • 7All EVV requirements shall apply to all providers, both agency-directed and consumer-directed, of personal care services, respite care services, and companion services unless exempt under subsection C (12VAC30-60-65.B).(12VAC30-60-65. Electronic visit verification.)

Applies to: All agency-directed and consumer-directed providers of personal care, respite, and companion services (with enumerated exemptions), fiscal/employer agents, and their attendants/aides in Virginia

Establishes Virginia's Medicaid electronic visit verification (EVV) requirements pursuant to the 21st Century Cures Act, requiring EVV to capture the type of service, individual, date, times of start/end, location, and provider for personal care, respite, and companion service visits. Sets exemptions, system functional requirements, adjustment authority, and a six-year data retention rule. Effective August 18, 2021.

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