EVV Hard Launch Information

On May 1, 2023 the Wisconsin Department of Health Services (DHS) implemented the hard launch of the Electronic Visit Verification (EVV) system for hands-on cares for the following Service codes:

  • T1019 and T1020 – Personal Care services; per 15 minutes and per diem
  • S5125 and S5126 – Attendant Care services; per 15 minutes and per diem

Claims will be denied for dates of service on May 1, 2023 and thereafter, if EVV requirements are not followed. Below are a few resources, reminders, and supports to assist impacted providers.


Important Reminders

EVV Visit Key Needed: Workers are required to check in/out using an EVV system at the start and the end of each visit. Claims without an EVV Visit Key will be denied. The EVV Flyers above provide further details regarding the EVV Visit Key.

No Date Span Billing: Claims for the related services must be submitted separately for each date of service. Claims submitted using date span billing will be denied. The WPS EVV Provider Billing Facts link above provides further details and helpful tips regarding claims and billing.

Date Span Example: A member received services on 14 dates in the month of May. Date span billing is when a date span of 5/1/2023–5/31/2023 is submitted for total units (days) and total charges. Instead, submit each day separately with units and charges on 14 individual claim lines.


Wisconsin EVV Customer Care is available to provide support throughout the process. Customer Care is accessible by email at vdxc.contactevv@wisconsin.gov or phone at 833-931-2035 Monday–Friday, 7 a.m.–6 p.m. CT.

Inclusa Authorization and Claims Support Team is available to provide support with authorization and claims:

Inclusa Provider Relations Team is available to provide support with contracting questions. Please contact your local Program Manager, ProviderRelations@inclusa.org, or 877-622-6700, option 2, then option 3.

2023-05-25T19:11:35+00:00April 6th, 2023|Provider Announcements|

2022 American Rescue Plan Act – Impacted Services

2022-03-07T17:32:21+00:00March 7th, 2022|Provider Announcements|

2021 State Directed HCBS Rate Increase – Impacted Service Codes

Family Care HCBS Inclusion Logic

SPCs Covered

102.00 Adult Day Care
110.00 Daily Living Skills Training
706.00 Day Habilitation Services
202.11 AFH 1-2 bed (care&supervision)
202.22 AFH 3-4 bed (care&supervision)
506.71 CBRF- 5-8 bed (care&supervision)
506.76 CBRF- greater than 8 beds (care&supervision)
711.02 RCAC- (care&supervision) daily
103.99 Respite Care
104.00 Supportive Homecare – Daily
104.20 Supportive Homecare
104.30 Supportive Homecare

Procedure Codes Not Covered

S5120 Chore Services, per 15 min
S5121 Chore Services, per day

Covered Supported Employment Codes

108.10 Prevocational Services
114.00 Vocational Futures Planning & Support
615.00 Supported Employment
615.10 Supported Employment- Integrated

Procedure Codes:

H2025 Supported employment, ongoing coaching
T2014 Community based prevocational services
T2015 Community based prevocational services
T2018 Integrated: 1-2 Members
T2019 Integrated: 1-2 Members
T2038 HJ Voc Futures Planning

Family Care Partnership HCBS Inclusion Logic

Procedure Codes Not Covered: A0000 through R9999
Revenue Codes Not Covered: 0550 through 0559

Procedure Codes Covered

99509 RN Supervisory visit for personal care
99600 Skilled Nursing services
H2014 Daily Living Skills Training
S5100 Day care services, adult; per 15 minutes
S5101 Day care services, adult; per half day
S5102 Day care services, adult; per diem
S5105 Adult day care:
S5125 Attendant Care, per 15 mins
S5126 Attendant Care, per day
S5130 SHC-Routine Health Care Service
S5136 Supportive Home Care – per day: Community Supported Living
S9125 Respite care-institutional setting, per diem
T1005 Respite care in the home, per 15 minutes
T2012 Daily Living Skills; per day
T2013 Daily Living Skills per hour
T2021 Day Services; per 15 minutes
S5135 Companion Care; per 15 min
T2020 Community-Based Day Services, per day

Revenue Codes Covered

0220 AFH bedhold ancillary residential care services only; per day
0229 CBRF bedhold ancillary residential care services only, day
0240 AFH- 1-2 bed C/S
0241 AFH- 3-4 Bed C/S
0242 CBRF < 8 bed C/S
0243 CBRF > 8 bed C/S
0670 RCAC- C/S
0672 SHC- C/S

Supported Employment Codes Covered

H2025 Supp Employ Coaching, hour
T2014 Prevocational services; per diem
T2015 Prevocational services; per hour
T2018 Supported Employment
T2019 Supported Employment
T2038 HJ Voc Futures Planning
2022-03-07T17:57:12+00:00July 9th, 2021|Provider Announcements|

DHS Notice – 2021 State Directed Rate Increase for HCBS Providers


Wisconsin Department of Health Services

2021 State Directed Rate Increase for Home and Community-Based Service Providers

Home and Community-Based Services Provider,

The Wisconsin Department of Health Services will provide funding to the MCOs for the 2021 State Directed Rate Increase for home and community-based services, which the MCO will distribute to home and community-based services providers.

Home and community-based services provider means a provider of adult day care services, daily living skills training, habilitation services, residential care (adult family homes of 1-2 beds, adult family homes of 3-4 beds, community-based residential facilities, residential care apartment complexes), individual and group supported employment, prevocational employment, vocational futures planning, respite care services provided outside of a nursing home, and supportive home care. Providers of self-directed services are not eligible for this increase for self-directed services. Nursing homes and personal care agencies are not home and community-based services providers.

MCOs are required to provide a unit rate increase to all eligible providers equal to 4.24% of each eligible provider’s rates for Family Care and Family Care Partnership covered services in effect on June 1, 2021. The 4.24% unit rate increase on covered services equates to a unit rate increase of 3.51% when calculated on covered and non-covered services for residential providers. This unit rate increase will be labeled “2021 State Directed Rate Increase” in provider contracts as a separate line item from other components of the contracted rate with the provider. MCOs may negotiate other components of the MCO’s reimbursement rates to providers.

MCOs will be communicating the details of this increase and the associated contract amendment. Timely responses to these updates and submission of requested claims resubmissions dating back to the retroactive start of this increase, June 1st, 2021 will help ensure timely payment of this increase to providers.

Please contact DHSLTCFiscalOversight@dhs.wisconsin.gov if you have any general questions about the 2021 State Directed Rate Increase.

2022-03-07T17:20:51+00:00July 9th, 2021|Provider Announcements|
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