Health Partners Plans (HPP) would like to thank you for continuing to be a participating provider and would like to provide some NEW important and REMINDER information regarding Electronic Visit Verification (EVV).

NEW EVV INFORMATION

Per DHS Bulletin #05-22-08, 07-22-02 – Additions to the Medical Assistance Fee Schedule for Private Duty Nursing Services Provided to Beneficiaries Under the Age of 21, effective 2/1/2023 HPP will begin to utilize T1002 and T1003 exclusively for authorization requests for Private Duty Nursing Services for our Pediatric Shift Care members.

T1002 - RN services, up to 15 minutes

T1003 - LPN services, up to 15 minutes

To eliminate any disruption during the transition to T1002 and T1003, HPP will honor all existing approved authorizations with S9123 and S9124 and no changes will be required on your end.  HPP will continue to authorize S9123 and S9124 for pediatric shift care for services needed until 1/31/2023.  For services that are requested on 2/1/2023 and thereafter, S9123 and S9124 will no longer be available for pediatric shift care services authorization requests and T1002 and T1003 will be exclusively authorized for pediatric shift care.  Providers must bill and will only be reimbursed for the specific code approved in their pediatric shift care authorizations regardless of the date of service, date of claim submission, or date the claim was processed.

The rounding rules to indicate a unit based on the Clock-in and Clock-out times will also apply to these services.

EVV REMINDER INFORMATION

EVV was implemented due to Section 12006 of the Twenty First Century Cures Act (Cures Act) and the Centers for Medicare & Medicaid Services (CMS) requiring the utilization of Electronic Visit Verification System (EVV) for all Personal Care Services by January 1, 2021 and all Home Health Care Services by January 1, 2023.  As a reminder, the Cures Act Mandate requires all visits to be timestamped via an electronic verification method utilizing EVV tools to record the member, caregiver, location of the service, date of the service and the type of service performed.

HPP is partnered with HHAeXchange to provide a free EVV and billing tool for member placement, scheduling, authorization management, communication and EVV compliance for Home Health Aide services.

At this point in time, you should be utilizing one of the HHAX Platform Options.

Please visit www.HPPlans.com/PolicyBulletins for HPP’s reimbursement policy for multiple members receiving Home Health Aide or Skilled Nursing services in the same household by the same provider of care - (RB.025.A  – Pediatric Shift Care When Multiple Members in a Household are Receiving Care.

Have Questions?

If you have questions or need help, please feel free to contact your Health Partners Plans provider representative Rhonda Colbourne at 215-991-4091 or RColbourne@hpplans.com. For questions or help with HHAX, please email HHAeXchange at Support@HHAeXchange.com or visit us at https://hhaexchange.com/pa-epsdt/.             

Thank you for your support in providing the highest quality of care to our members.