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Caregiver Scheduling

Will this visit get paid?

Review yesterday's visits before billing. Enter the scheduled and actual times, how the caregiver clocked in and what went wrong, and get a pass or fail against your state's EVV rules, the reason code to attach, what to fix, and the date the visit locks.

Last reviewed November 5, 2026

Scheduled
Actual (EVV)
How was the visit recorded?
Verified on the record

Texas · Medicaid MCO · T1019

Pays with a reason code

1 item needs a reason code. Attach it during visit maintenance; the claim then matches.

  • Passed: All six Cures Act elements capturedService, member, caregiver, date, location, start and end time are on the record.
  • Passed: Clock-in and clock-out both recorded08:07 to 11:58, 231 minutes.
  • Passed: Recorded by mobile app with GPSAn electronic method; no reason code needed for the method itself.
  • Passed: Location verifiedLocation matches the member’s address or a recorded community location.
  • Passed: Within 15 minutes of the scheduleClock-in +7 min, clock-out -2 min. No variance code needed.
  • Needs attention: Bill 15 units (231 min under the 8-minute rule)1 fewer units than scheduled; bill the verified 15, not the schedule.
Reason code to attachNone needed
Visit locks—95-day visit maintenance window
Billable15 unitsafter reason codes

Caregiver Scheduling records time, GPS location, the client’s signature and any override reason at every check-in and check-out, shows the office every override on the visit, and exports for state EVV aggregators.

EVV-compliant check-in
Email
Nothing you enter is stored except your state. No member names.

EVV in Texas

TMHP EVV aggregator, open model, 95-day correction window.

AggregatorTMHP EVV Aggregator (Texas Medicaid & Healthcare Partnership)
ModelOpen: the state-funded HHAeXchange system at no cost, or a proprietary system approved by HHSC and TMHP that exports to the aggregator
State systemHHAeXchange (replaced AuthentiCare and Vesta October 1, 2023)
Approved vendorsHHAeXchange, or an HHSC-approved Proprietary System Operator (PSO). The PSO list is on the TMHP EVV page.
Services with EVVPersonal attendant services, in-home respite, CFC PAS/HAB, Community Attendant Services, PCS, CDS option, and Home Health Care Services (skilled nursing, therapy, HHA visits) under the Cures Act expansion.
RoundingBilled units follow the HHSC EVV Service Bill Codes Table; visit minutes are matched to claim units at the aggregator. 15-minute units for PAS/CAS.
Visit maintenance window95 calendar days from the date of service
Key dates95 calendar days from the date of service for all visit maintenance, including manual visits. HHSC compliance reviews: 80% EVV usage score threshold and reason-code misuse reviews.
Who to callHHSC EVV Operations (evv@hhs.texas.gov); TMHP EVV Portal; HHAeXchange Texas support; your MCO's EVV team.

Reason codes used here

  • 100 series: Schedule variationVisit outside the scheduled time with the member's agreement
  • 200 series: No electronic clock in or clock out210 J: EVV system down; 210 I: emergency; phone or device unavailable
  • 300 series: Member/service provider issueMember refused, service provider error
  • 500 series: Invalid dataWrong member, provider or service code corrected
  • 600: OtherFree text required
  • 900 series: PreferredPreferred reason codes do not count against compliance review

If the claim denies

Perform visit maintenance in the EVV system (reason code required), confirm the aggregator accepts the transaction, then submit the EVV claim to TMHP or the MCO. A claim that does not match an accepted EVV visit is denied with an EVV match code; fix the visit and rebill. After 95 days the visit locks; corrections need a Visit Maintenance Unlock Request approved by the payer (decided within 10 business days; 20 business days to complete).

The six things every visit must prove

The Cures Act list, and what breaks each one.

  1. Type of service. Wrong code or modifier for the program; the aggregator rejects.
  2. Individual receiving the service. Member ID mismatch between EVV and the claim.
  3. Individual providing the service. Caregiver not linked to the agency, or credential lapsed on that date.
  4. Date of service. Overnight visits that span midnight without a split.
  5. Location. GPS outside the geofence with no community-visit reason.
  6. Start and end time. Missing clock-out is the single most common exception.

How Caregiver Scheduling handles this

Every check-in and check-out in Caregiver Scheduling stores the time, the GPS location and its distance from the home, the client’s signature and any override reason with the visit. That covers the six data points the 21st Century Cures Act requires, and visits export for state EVV aggregators. See GPS check-in and EVV.

Sources

Frequently asked questions

In an open model the state names an aggregator and lets you capture visits in any certified system that sends data to it. In a closed (state-mandated) model you must use the state’s system directly, as Maryland does with ISAS. Several states are hybrids: the state system is free, alternates are allowed after certification.

Related guides

EVV

Why EVV Claims Get Denied and How to Fix Them

EVV claims are denied when the claim line does not match an accepted visit: client ID, date, provider, service code or units. How matching works, the seven causes, and a routine that keeps denials low.

EVV

EVV Exception Codes and Visit Corrections

An EVV exception is a visit that did not verify cleanly. Fix it with the state's reason code, a note and approval, inside the correction window, and keep the original.

EVV

Does EVV Apply to Private Pay Clients?

No. Federal EVV law covers only Medicaid personal care and home health visits. Private-pay, LTC insurance and VA visits are outside it, but verified visits still protect you on payroll and billing.

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