MedicaidAdministrativeHigh impact
Newsletter Vol. 31, No.21
New Jersey Medicaid·NJ · Psychiatry·Reimbursement
Effective date
Oct 1, 2021
We identified it
Jun 20, 2026
Summary
New Jersey's Division of Medical Assistance & Health Services mandates Electronic Visit Verification (EVV) compliance for Agency Hired Respite (AHR), Intensive-In-Home Behavioral (IIH-B), and Individual Support Services (ISS) providers effective October 1, 2021. Providers must implement EVV systems through HHAeXchange or their own approved third-party solution to record all in-person visits; service encounter forms are eliminated. Non-compliance risks loss of new referrals and claims payment denial.
Action Required
By October 1, 2021: CSOC providers billing for AHR, IIH-B, or ISS services must be fully compliant with EVV mandate. Specific actions required: (1) Complete Provider Portal Survey at Provider Portal Questionnaire; (2) Follow EVV welcome packet directions from HHAeXchange or submit EDI welcome packet if using third-party EVV solution; (3) Complete System User Training (recordings available on NJ CSOC Information Center); (4) Begin submitting all EVV visit data to HHAeXchange for every in-person service encounter, including entire length of visit. Providers with custom EVV systems must initiate integration with HHAeXchange and comply with published Business Requirements and API Technical Specifications. Eliminate use of service delivery encounter forms immediately. Continue all prior authorization and Cyber system workflows unchanged. Consequences: Providers demonstrating lack of good faith EVV compliance will not receive new service referrals and will not receive payment for services. Billing team should verify all claims submissions include proper EVV verification before processing. Contact DCF.EVVCSOC@dcf.nj.gov or mahs.evv@dhs.nj.gov with compliance questions.