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Provider Payment: EVV Claims Payment for Medicaid/NJ FamilyCare Providers Billing for PCA Services - Volume 31 No. 16
New Jerseysub_regulatoryNJ Department of Human Services, Division of Medical Assistance & Health Services (DMAHS)
What this rule requires your agency to do
- 1Agency providers of personal care services must confirm all visits with EVV using HHAeXchange, CareBridge, or an integrated third-party EDI solution and bill using the payer's designated EVV billing process to be Operational.(Provider Payment: EVV Claims Payment for Medicaid/NJ FamilyCare Providers Billing for PCA Services - Volume 31 No. 16)
- 2Providers must complete a one-time attestation of their EVV compliance status effective July 1, 2021, documenting reasons for any payer with which they are not fully operational.(Provider Payment: EVV Claims Payment for Medicaid/NJ FamilyCare Providers Billing for PCA Services - Volume 31 No. 16)
- 3Providers must submit and bill EVV-mandated services through the correct payer-specific solution (HHAeXchange for FFS/Aetna/United/WellCare; CareBridge for Amerigroup/Horizon).(Provider Payment: EVV Claims Payment for Medicaid/NJ FamilyCare Providers Billing for PCA Services - Volume 31 No. 16)
- 4Providers must move from Provisional to Operational status no later than September 30, 2021; providers not demonstrating EVV compliance are at risk of not receiving new referrals and may have existing cases moved to Operational providers.(Provider Payment: EVV Claims Payment for Medicaid/NJ FamilyCare Providers Billing for PCA Services - Volume 31 No. 16)
Applies to: personal care
DMAHS newsletter setting EVV compliance/payment requirements for PCA providers effective July 1, 2021, defining Operational vs. Provisional status and the one-time attestation and transition deadlines.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.