We are writing to inform you that a Department of Human Services (DHS) statewide mandate will change how Jefferson Health Plans processes Electronic Visit Verification (EVV) authorizations.

Effective 10/1/2023, Jefferson Health Plans EVV authorizations processing will be as follows:

1. Any authorization that is currently approved for T1019 service code and has authorization dates that end prior to 10/1/2023: Take no action at this time; these authorizations are not affected by this change.
2. Any NEW requests for T1019 services will be honored up until the date of 9/30/2023. Beginning on 10/1/2023, only G0156 with U7 modifier will be allowed to be used.

For example, a provider that requests an authorization for home health aide services will be given an authorization for T1019 through date of service 9/30/2023, then for G0156 U7 from 10/1/2023 through the end date of the authorization.

Any authorization that is currently approved and has an authorization span date across the date of 10/1/2023 will be amended by Jefferson Health Plans so that the T1019 service code ends on 9/30/2023 and G0156 with U7 begins on 10/1/2023. Please note: You will need to submit claims with the new service code and modifier starting on 10/1/2023 to receive payment.

It is imperative that providers tell us at the time of the request for G0156 if the care is being provided by a LRR (legally responsible relative) (SC modifier), and for providers to tell us if this status changes at all throughout the life of an authorization. Failure to notify Jefferson Health Plans will result in claims not paying correctly.

The order of modifiers on the claim submitted to Jefferson Health Plans is important.  If you need to include the modifier “TT” in your claim for service code G0156, please be sure to list that modifier first. Modifiers should be listed as shown in this order, if applicable: 1^st TT; 2^nd U7; 3^rd SC.

If you have additional questions, contact our Provider Services Helpline at 1-888-991-9023, Monday – Friday, 9:00 a.m. – 5:30 p.m. Thank you for your support in providing the highest quality of care to our members.