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Provider Manual

Home health care services

Last Updated on February 19, 2026

Security Health Plan follows ForwardHealth guidelines for our Medicaid Managed Care Program.

Security Health Plan requires prior authorization for all home health care services. Please see the “Home Care Coverage Criteria” medical policy on the Security Health Plan Medical Policy webpage for information on prior authorization criteria.

In alignment with ForwardHealth, Security Health Plan will require electronic visit verification (EVV) for Medicaid-covered home health services.

  • The soft launch effective date is date of service January 1, 2024
  • The hard launch effective date is date of service October 1, 2024
This applies to all workers, including live-in workers. 

The following codes will require use of an EVV System:

  • 92507 (Treatment of speech, language, voice, communication and/or auditory processing disorder; individual [per visit])
  • 97139 (Unlisted therapeutic procedure [specify] [per visit])
  • 97799 (Unlisted physical medicine/rehabilitation service or procedure [per visit])
  • 99504 (Home visit for mechanical ventilation care [per hour])
  • S9123 (Nursing care, in the home; by registered nurse, per hour)
  • S9124 (Nursing care, in the home; by licensed practical nurse, per hour)
  • 99600 (Unlisted home visit service or procedure [per visit])
  • T1001 (Nursing assessment/evaluation [per visit])
  • T1021 (Home health aide or certified nurse assistant, per visit)
  • T1502 (Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit)

General information about EVV

EVV is a system that uses technology to verify that authorized services were provided. Through EVV, a worker providing personal care services or supportive home care services sends visit data to an EVV vendor at the beginning and end of each visit using methods such as a mobile application, landline, or fixed device.

Workers using EVV enter information to record:

  • Who receives the service
  • Who provides the service
  • What service is provided
  • Where the service is provided
  • The date of the service
  • The time the service begins and ends

The Department of Health Services (DHS) provides an EVV system through Sandata at no cost to Wisconsin providers. The DHS-provided Sandata EVV system can be used by all programs, providers and payers. Providers may choose whether to use this system or an alternate EVV system (that is, any system besides the DHS-provided Sandata system). Aside from providing the DHS Sandata system free of charge (including fixed visit verification [FVV] devices, as needed), DHS does not reimburse for costs related to EVV, including hardware, software, or training.

The Sandata system provided by DHS offers three ways to collect EVV information:

  • The Sandata Mobile Connect (SMC) app —The worker uses a smart phone or tablet to check in and out of visits. The app does not require Wi-Fi or cell service at the time of the visit.
    • This is the preferred method because it captures information with the fewest errors.
  • Telephonic visit verification (TVV)—The worker uses the member’s landline or fixed Voice over Internet Protocol  (VoIP) phone to call in and out of the visit.
    • TVV uses the same technology as 911 to confirm location. Cell phones may not be used for TVV.
  • Fixed visit verification (FVV)—At the beginning and the end of the visit, the worker pushes a button on a small device that generates a code. The FVV device does not transmit the EVV information. The codes must later be called in to the TVV line.
    • This is the method of last resort and may only be requested if the worker and the member meet all the criteria in ForwardHealth Handbook Topic #21878.

None of the three methods require cell or internet connection during the visit.

Providers can instead choose to use an alternate EVV system (that is, any system besides the DHS-provided Sandata system). Alternate EVV systems must connect with the Sandata aggregator, a technology that collects all EVV information and ensures the validity of the information before it is sent to the assigned payer.

Claim matching to an EVV

Submit claims for home health services to Security Health Plan. We will review to ensure there is an approved authorization on file. If the claim is payable, we will then check if we have received an EVV for the claim line. 

Each night Sandata sends verified visits (those that have no errors or missing information) to DHS. DHS then sends the visits in a daily file to Security Health Plan. Security Health Plan will use the file to match claims received. 

If a visit is not in a verified status, it will not be sent to DHS and Security Health Plan. The provider must correct or add the missing information in the EVV system. 

Manually entered or corrections to visit information

It is best practice to capture all EVV information during the visit in order to prevent additional administrative work after the visit, claim denial or other negative consequences. DHS and Security Health Plan recognize this is not possible in all cases and you may have to manually enter or correct visit information in order to fully and accurately capture the details of the visit. Manually entered visits should only be used when absolutely necessary.

  • Providers using the DHS-provided Sandata EVV system should enter this information using the provider’s Sandata EVV Portal.
  • Providers using an alternate EVV system should refer to their vendor for instructions on how to create or correct visit information manually.

All manually entered visits and corrections will require an associated reason code to explain why the EVV data was created or changed and will be reviewed for compliance with policy. The provider must retain and maintain documentation of the reason for manual entry or corrections.

What is the difference between a “soft launch” and a “hard launch”?

DHS will be rolling EVV for home health care services in two phases, a "soft launch" and "hard launch." The soft launch is a period in which all provider agencies and workers will be required to use EVV, but it will not be integrated into claims processing.

The soft launch date is effective for claims with date of service 01/01/24 or after. Claims will NOT be denied during the soft launch phase. It will be a time to cooperatively overcome any initial hurdles and help establish processes. 

The hard launch is when DHS will require home health care claims to have an EVV on file, or they may be denied. The hard launch date is effective for claims with date of service 10/01/2024 and after.

 

Don't miss out on  DHS communication

DHS will communicate important information through email. Please take the following actions to ensure you don’t miss out on communications:

Action 1

Make sure your most current information is listed in the ForwardHealth Portal. Provider administrators should go to ForwardHealth Portal (wi.gov) and log in to their secure ForwardHealth Portal account. From there, follow these steps to update their information:

  1. Select Providers tab at the top of the page
  2. Find Home Page to the right
  3. Select Demographic Maintenance
  4. Select Mailing Address
  5. Update your email address/contact name

Action 2

Provider administrators and other staff interested in receiving updates about EVV should also sign up to receive emails from DHS about EVV as they become available.

Reach out to Wisconsin EVV Customer Care for any EVV questions. Contact them at vdxc.contactevv@wisconsin.gov or 1-833-931-2035 Monday-Friday, 7 a.m.–6 p.m. CT.

DHS Resources