What Texas requires
EVV usage score
Texas measures EVV compliance with a usage score; falling under 80% triggers compliance review. Providers have a 95-day window to maintain visit data.
Source: Texas HHSC EVV compliance policy
Claims matching
Texas Medicaid matches claims against accepted EVV visit transactions; a claim with no matching accepted visit is denied.
Source: Texas HHSC EVV claims matching
Reason codes
Texas publishes a structured reason-code system for visit maintenance. Only one code is designated 'non-preferred': 900, the caregiver failed to clock in or out. Code families cover schedule variance (100 A–J), device/app failures (201, 300 A–H), and telephony issues (400 A–C).
Source: HHSC EVV Reason Codes guide
Edit-rate / usage rule
Texas requires an 80% EVV usage score with a 95-day visit-maintenance window. Falling under 80% triggers compliance review.
How the usage score works against you quietly
The usage score measures how much of your visit volume was captured and maintained through EVV properly. Manually entered visits and heavily edited visits drag the score down even when the claims ultimately pay — so an agency can have healthy cash flow and a failing score at the same time, and only find out at compliance review.
Reason-code discipline is the Texas skill
Texas's reason-code system makes edit quality visible: every visit maintenance action carries a code, only 900 (caregiver failed to clock in/out) is branded non-preferred, and free-text explanations are mandatory in most families. Agencies that train coordinators to pick precise codes — schedule variance vs. device failure vs. telephony — build an audit trail that reads as competence. Agencies that default everything to the same code build one that reads as concealment.
The 95-day maintenance window is generous but finite: visits left unmaintained past it are locked out of the usage score entirely.
What are Texas EVV denials costing you?
The free X-Ray reads your Medicaid 835 in your browser and shows the EVV denials. The file never leaves your computer.
Run the free Denial X-Ray