EVV Reason Codes

Please click here to see the reason codes in PDF format.

The Texas Department of Aging and Disability Services (DADS) has developed a presentation that provides an overview of how the use of the electronic visit verification (EVV) system and reason codes impact provider compliance under the Compliance Plan.

Each time a change is made within the Electronic Visit Verification (EVV) system, a reason code must be entered to provide the Texas Department of Aging and Disability Services (DADS) with information regarding the reason a change was made to the electronic record.

The following reason codes must be used when making updates or corrections in Visit Maintenance and when manually verifying visits. There is also the ability to add free text in the Comments section to provide additional information. However, a reason code(s) must first be selected before adding supporting comments. Providers and Consumer Directed Services (CDS) Employers must associate appropriate reason code(s) with each update made in Visit Maintenance.

Reason codes fall into one of two categories:  Preferred Reason Codes and Non-Preferred Reason Codes.  A preferred reason code is a code that documents visit maintenance necessitated by a situation in which the provider staff are delivering and documenting services in accordance with DADS expectations. A non-preferred reason code is a code that documents visit maintenance that is necessitated by a situation in which the provider staff is not delivering and documenting services in accordance with DADS expectations.

When noting the actual time the service delivery occurred, Providers and CDS Employers must use the Comments field to clearly document the actual start and end times worked by the employee. Additionally, Providers and CDS Employers must use the Comments field when there are not calls to verify this information. The table below outlines all specific reason codes as well as examples of use.

Code Reason Code DADS Examples of Use
01 Wrong Phone Number —
Verified Services Were Delivered

DADS Examples of Use Reason Code 01 is used when calls for a visit are received from a number that is not recognized by the EVV system. This is a non-preferred reason code.

02 Invalid ID — PCA Verified

Reason Code 02 is selected when an attendant does not accurately enter the entirety of his/her employee ID into the EVV system. This is a preferred reason code.

03 Phone Unavailable —
Verified Services Were Delivered

Reason Code 03 is selected when an attendant cannot use the phone to call in/out of the system because the phone is in use when the service provision begins or ends (e.g., the individual is on the line with his/her doctor when the attendant begins their shift). If this becomes a routine issue, an FVV device should be ordered. This is a preferred reason code.

05 Multiple Calls For One Visit

Reason Code 05 is used when an attendant makes multiple calls for a single scheduled visit. Code 5 is not used if technical issues with the phone prevent the attendant from calling in. Code 18 should be used for technical problems with the phone. This is a non-preferred reason code.

06 Attendant Failed to Call In and Out — Verified services Were Delivered Reason Code 06 is used when an attendant fails to use the telephony portion of the system to call in/out of the EVV system. Free text is required; the provider records the hours worked in the comments field. This is a non-preferred reason code.
08 Fill-in for Regular Attendant

Reason Code 08 is selected when someone other than the scheduled attendant provides services. This is a preferred reason code.

10 Individual Does Not Have Home Phone — Verified Services Were Delivered Reason Code 10 is selected when an individual qualifies for and requires the use of an FVV device, but one has not yet been requested by the provider. If a provider encounters a frequent use of this reason code, the provider must contact DADS to request direction regarding documentation of the situation in question. This is a preferred reason code.
11 Companion Case

Reason Code 11 is selected when the attendant delivers services to two or more individuals in the same household and only uses telephony to call in/out once for the entirety of the visit. This is a preferred reason code.

13 Individual Refused Employee Use of Phone — Verified Services Were Delivered

Reason Code 13 is selected when an attendant cannot use the phone to call in/out of the system because the individual refuses to allow use of the phone in that particular instance (e.g., the individual does not trust a backup attendant and chooses not to allow the attendant access to the phone). If this becomes a routine issue, an FVV device should be ordered. This is a preferred reason code.

14 CDS Employer Time Correction

Reason Code 14 is only used by individuals using the consumer directed services option and need to correct an EVV entry. This is a preferred reason code.

15 Services Provided Outside the Home — Supported By Service Plan or Verified with Individual Receiving Services Reason Code 15 is selected when an attendant cannot use the phone to call in/out because service provision began or ended outside of the home in accordance with program policy. This is a preferred reason code.
16 Fixed Visit Verification Device Has Been Ordered (Initial or Replacement Order) Reason code 16 is selected when an FVV device has been requested, but the provider has not yet received the device; the device is not yet in place; or the device is not working. This is a preferred reason code.
17 Individual Does Not Have a Home Phone (Does Not Qualify for FVV) — Verified Services Were Delivered

Reason Code 17 is only used to document service delivery to individuals that do not have a home phone available for EVV and are authorized or scheduled to receive services less than once per week (e.g., MDCP respite and flexible family support services). These individuals would not qualify for an FVV device. This is a preferred reason code.

18 Phone Lines Not Working — (PCA Not Able to Call) — Verified Services Were Delivered Reason Code 18 is used to document service delivery when telephony calls are not possible due to technical problems (e.g., phone lines are down, individual's phone not working, etc.) This is a preferred reason code.
20 Attendant Failed to Call In — Verified Services Were Delivered

Reason Code 20 is used when an attendant fails to use the telephony portion of the system to call in using the EVV system. Free text is optional, unless the provider changes the "time out" noted in the system. If the "time out" is changed, then the actual "time out" is recorded in the free text field. This is a non-preferred reason code.

21 Attendant Failed to Call Out — Verified Services Were Delivered

Reason Code 21 is used when an attendant fails to use the telephony portion of the system to call out using the EVV system. Free text is optional, unless the provider changes the "time in" noted in the system. If the time in is changed, the actual "time in" is noted in the free text field. This is a non-preferred reason code.

22 Individual Agreed PCA Not Work Schedule

Reason Code 22 is selected when the PCA does not work and the individual was contacted and agreed to the change in schedule. This is a preferred reason code.

24 Downward Adjustment to Billed Hours

Reason Code 24 is used when the time billed is adjusted downward to offset rounding (e.g., 7:55 a.m. for a shift starting at 8:00 am and 11:05 am for a shift ending at 11:00 am). Free text is not required. This is a preferred reason code.

26 Medicaid Reinstatement: Services Hours Worked

Reason Code 26 is selected when visits that were documented on paper time sheets during the time period when the individual's Medicaid eligibility was suspended are entered into the EVV system through visit maintenance after the individual's Medicaid eligibility has been reinstated. This is a preferred reason code.

27 Schedule Variation

Reason Code 27 is used when the attendant provides more or fewer hours of service to the individual than scheduled. All situations that require documentation must be documented according to program policy. This is a preferred reason code.

99 Other

This code is selected when a provider must address a system exception that cannot be addressed using one of DADS pre-existing memo codes. This code must always be accompanied by a free text explanation denoting why use of this code was required. This is a non-preferred reason code.

top of page

Updated: September 2, 2014