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Electronic Visit Verification (EVV) Claims Payment for Home Health Care Services (Phase II) - Volume 33 No. 12

New Jerseysub_regulatoryNJ Department of Human Services, Division of Medical Assistance & Health Services (DMAHS)

What this rule requires your agency to do

  • 1Providers must ensure rendering provider certification and license numbers are included on all EVV-applicable claims; the requirement applies to CHHA, RN, LPN, PT, Cognitive Therapists, OT, and ST.(Electronic Visit Verification (EVV) Claims Payment for Home Health Care Services (Phase II) - Volume 33 No. 12)
  • 2For live-in caregivers, an EVV Live-In Worker Attestation must be completed (services provided by a caregiver living in the home are exempt).(Electronic Visit Verification (EVV) Claims Payment for Home Health Care Services (Phase II) - Volume 33 No. 12)
  • 3Home health, skilled care, and therapy providers (Cohorts 1 and 2) must secure EVV information for all covered in-home visits (POS 12/Home) and submit the six required EVV data elements.(Electronic Visit Verification (EVV) Claims Payment for Home Health Care Services (Phase II) - Volume 33 No. 12)
  • 4Providers must utilize the EVV-specific billing process for each payer and meet billing compliance for Cohort 2 services by August 1, 2023 and Cohort 1 services by October 1, 2023.(Electronic Visit Verification (EVV) Claims Payment for Home Health Care Services (Phase II) - Volume 33 No. 12)
  • 5Providers who fail to meet provisionally-engaged requirements are at risk of no longer receiving referrals, and disengaged providers must immediately address EVV requirements.(Electronic Visit Verification (EVV) Claims Payment for Home Health Care Services (Phase II) - Volume 33 No. 12)
  • 6Providers must complete onboarding requirements (select an EVV vendor, complete the HHAeXchange NJ Home Health Provider Enrollment Form, complete integration, and complete required HHAeXchange/CareBridge/EDI and MCO-specific training).(Electronic Visit Verification (EVV) Claims Payment for Home Health Care Services (Phase II) - Volume 33 No. 12)

Applies to: cross-cutting

DMAHS newsletter detailing Phase II EVV requirements for home health/skilled care/therapy services, including covered code cohorts, onboarding/operational milestones, and claims-compliance and certification requirements.

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