Electronic Visit Verification
Electronic Visit Verification (EVV) is a technology used to verify that home or community-based service visits occur. The purpose of EVV is to ensure that services are delivered to members and that providers only bill for services rendered.
In Colorado, EVV has been mandatory since August 3, 2020
If you provide services that require EVV and have not yet enrolled, you MUST complete enrollment immediately to avoid potential denied claims!
What's New with EVV
New procedure codes are being introduced for Community First Choice (CFC) services starting July 2025. This does not change EVV data collection requirements. However, providers using a Provider Choice System must ensure their system is updated to recognize the new procedure codes and continue mapping to the correct EVV service group codes (which remain unchanged).
Refer to the Crosswalk of Codes – July 2025 and the EVV Program Manual for guidance.
The purpose of the Operational Memo is to announce revised operational processes and timelines for Electronic Visit Verification (EVV) exemptions for live-in caregivers (LICs) and reasonable modifications under the Americans with Disabilities Act (ADA) for EVV exemptions. The memo is intended for the billing providers and agencies that deliver and perform billing for EVV-required services, as well as guidance for caregivers, and Health First Colorado (Colorado’s Medicaid Program) Medicaid members.
The memo details revised billing provider responsibilities when declaring an EVV exemption for live-in caregivers including extenuating circumstances and reasonable modifications under the ADA and includes revised operational processes and methods for applying for EVV exemptions, and billing for services with EVV exemptions. The updated operational methods include the utilization of the Gainwell Provider Web Portal and the revised EVV Attestation of Exemption Form (EVV Exemption Form), which can be found on the EVV Newsletters and Resources page.
Additional information can be found in Operational Memo 25-008 - Revised EVV Exemption Process - January 2025.
Please consider providing your user experience feedback here.
There’s more to come! Get updates when you subscribe to the EVV Newsletters and don’t forget to attend the EVV Stakeholder Meetings.