Below are the Electronic Visit Verification (EVV) mandated services and service codes. If providers are billing these services, they will be required to use EVV to clock in and clock out.
HCBS DD WAIVER SERVICES (CDD AND DDAD)
|
| SERVICES | SERVICE CODES | PROVIDER TYPE |
| Independent Living | 2639
| Agency and Independent |
| Supported Family Living | 7494 | Agency and Independent |
| Medical In-Home Habilitation | 9220 | Agency |
Behavioral In-Home Habilitation
| 1796 | Agency |
| Respite | 2656
| Agency
|
Respite (In-Home)
| 8148
| Independent |
| Homemaker | 9393 | Independent
|
| Homemaker | 9769 | Agency
|
HCBS AD WAIVER SERVICES
|
| SERVICES | SERVICE CODES | PROVIDER TYPE |
Chore (Discontinued 10/31/21)
| 1691
| Agency and Independent
|
Personal Care (Effective 11/1/21)
| 5761
| Agency and Independent
|
Companion (Effective 11/1/21)
| 9510
| Agency and Independent |
| Respite Care -- (In-Home) | 1113
| Agency and Independent
|
Disability related Child-Care -- In Home
| 2500
| Agency and Independent
|
| MEDICAID PAS |
| SERVICES | SERVICE CODES | PROVIDER TYPE |
Personal Assistance
| 4475
| Agency and Independent
|
HCBS TBI WAIVER SERVICES
|
| SERVICES | SERVICE CODES | PROVIDER TYPE |
TBI Personal Care
| 6222
| Agency and Independent
|
TBI Companion
| 7934
| Agency and Independent
|