Electronic Visit Verification (EVV) Newsletter

Hello and welcome to the Electronic Visit Verification (EVV) Newsletter - a newsletter with timely content on important updates, best practices, and resources to support your EVV experience.

EVV Newsletter Highlights

• What is EVV?
• What's New with EVV?
• Reminders

What is EVV?

Electronic Visit Verification (EVV) is a technology used to verify services in the home and community. EVV aims to ensure that services are delivered to people needing those services and that providers only bill for services rendered.

What's New with EVV?

Electronic Visit Verification Rule Updates and Stakeholder Feedback Opportunity

The Department of Health Care Policy & Financing (HCPF) is proposing updates to the Electronic Visit Verification (EVV) rule at 10 CCR 2505-10 Section 8.001. The proposed revisions include citation updates, terminology and language updates for clarity and consistency, and a new requirement for EVV when certain fee-for-service services are provided in a school setting.

Under the proposed rule language, providers would be required to utilize EVV when the following services are provided in Place of Service 03 - School:

• Pediatric Behavioral Therapies
• Physical Therapy 
• Occupational Therapy
• Speech Therapy

These services are already subject to EVV requirements when provided in the home or community. The proposed update clarifies that EVV would also be required when these fee-for-service services are provided in a school setting. This change supports consistent EVV requirements across service locations, strengthens program integrity, and aligns with HCPF’s broader efforts to support payment accuracy and prevent fraud, waste, and abuse.

HCPF anticipates that these rule changes will be effective March 2, 2027. HCPF is seeking stakeholder feedback on the proposed rule revisions. Please share any comments or questions by September 1, 2026 using this feedback form or by emailing EVV@state.co.us.

There will also be a public rule review meeting on November 11, 2026 and the rule is expected to go to the Medical Services board on December 11, 2026.

Upcoming EVV General Stakeholder Meetings

To support the implementation of the EVV Rule updates, there will be two EVV General Stakeholder Meetings scheduled to review the proposed changes and collect stakeholder feedback. These meetings are scheduled:

• Meeting 1: August 4, 2026 from 11AM -12 PM
• Meeting 2: August 11, 2026 from 11AM -12 PM

Register to Attend via Zoom

Reminders

Temporary Pause on Provider Portal Live-in Caregiver EVV Exemption Requests Remains in Effect

The Department of Health Care Policy and Financing (HCPF) continues to receive live-in caregiver Electronic Visit Verification (EVV) exemption requests through the Gainwell Provider Web Portal. This article serves as a reminder that the temporary pause on submitting new live-in caregiver EVV exemption requests through the Provider Web Portal remains in effect until further notice, as announced in Operational Memo 25-068.

During the temporary pause:


• Do NOT submit new live-in caregiver EVV exemption requests through the Gainwell Provider Web Portal.
• Continue to maintain all required live-in caregiver exemption documentation, including the Attestation of Exemption Form and supporting documentation, in accordance with HCPF requirements.
• Keep exemption documentation current and available upon request for HCPF verification or audit.
• Continue to submit EVV records for services that require EVV.
• Continue annual renewal of live-in caregiver exemptions WITHIN your organization's records.
  

Providers who submit live-in caregiver EVV exemption requests through the Provider Web Portal during the temporary pause may receive a rejection notice. These requests are not being processed while the temporary pause remains in effect.

HCPF will notify providers when the Provider Web Portal live-in caregiver EVV exemption process resumes.

For additional information, please refer to Operational Memo 25-068: Temporary Pause of the Provider Portal EVV Exemption Process for Live-in Caregivers.

Program Integrity Reminder: Align EVV Records with Claims 

Accurate alignment between Electronic Visit Verification (EVV) records and Medicaid claims is a core program integrity requirement. Provider agencies are responsible for ensuring that billed units accurately reflect verified EVV visit duration and that discrepancies are identified and corrected before claims are submitted.

HCPF has identified provider-level instances where EVV visit duration data did not align with units billed to Medicaid. These discrepancies are considered unjustified payments and may be subject to review and recovery.

Providers should regularly review their EVV and billing processes to ensure:

• EVV visit duration accurately reflects services delivered.
• Billed units align with verified EVV data.
• Discrepancies are identified and corrected promptly.

As part of HCPF's ongoing program integrity efforts, providers identified through data analysis as having billing misalignments will receive EVV reports outlining observed trends. Providers are expected to review these reports and improve compliance before additional corrective action becomes necessary.

Need to Make an Accommodation Request for any of our EVV-related Meetings?

Reasonable accommodations for the meetings will be provided upon request for persons with disabilities. Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request.

Please contact HCPF's 504/ADA Coordinator at hcpf504ada@state.co.us at least one week prior to the scheduled meeting to make arrangements.