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EVV Claim Units Matching Effective October 30, 2026 for In-Home Respite Services in CLASS and DBMD Programs
Effective date
Oct 30, 2026
Identified
Nov 4, 2026
Summary
Effective October 30, 2026, Texas HHSC now requires exact unit matching between Electronic Visit Verification (EVV) records and claims for in-home respite services under CLASS and DBMD programs. Claims with mismatched units will be denied with an EVV06 rejection code. Billing teams must verify EVV units match claim units before submission.
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What to do
Action · 5 steps
01Effective October 30, 2026: Billing team must verify that units on accepted EVV visits in the EVV Aggregator exactly match the units being billed on claims for service code G0100 (In-Home Respite) in CLASS program (service group 211) and DBMD program (service group 161) before submitting claims.
02Update charge entry and claim validation procedures to compare EVV units against claim units and flag or hold any claims with unit mismatches.
03Train billing staff to review EVV Aggregator records and reconcile units prior to claim submission.
04Communicate this requirement to providers and front desk staff so they understand that EVV documentation must be complete and accurate before billing occurs.
05Watch for claim denials with EVV06 result codes and investigate unit discrepancies; resubmit corrected claims once EVV and billing units are aligned.
Codes mentioned
G0100
Original notice
EVV Claim Units Matching Effective October 30, 2026 for In-Home Respite Services in CLASS and DBMD Programs
tmhp.com · Always check the source before changing claims.