Michigan Electronic Visit Verification (EVV) Data Aggregator API Specifications
This specification provides guidance and instructions in preparing data for import to HHAeXchange. Herein are the various Application Programming Interface (API) endpoint definitions indicating required fields and proper format for a successful import.
The topic is intended for project management and technical teams at designated providers and/or Electronic Visit Verification (EVV) vendors who are implementing this interface.
Submit a General inquiries ticket for EVV aggregation to 3rd Party Integration Support Desk. Include 'State Abbreviation' EVV General Inquiry in the subject line. Cases are escalated to the Integration Support queue. An available team member will contact you to assist.
| Index | Element | Description | Max Length | Type | Required | |
|---|---|---|---|---|---|---|
| 1 | providerTaxID | Provider Tax ID - Unique Identifier for the Provider. Format: 999999999 | 9 | String | Required | |
| 2 | qualifier | Identifier being sent as the unique identifier for the Caregiver. Possible Values: ExternalID | 50 | String | Required | |
| 3 | externalID | Unique Caregiver identifier in the external system. | 20 | String | Required | |
| 4 | ssn | Provider and EVV vendors should only send a default value of ‘999999999’ for the social security number field Format: 999999999 | 9 | String | Required | |
| 5 | dateOfBirth | Caregiver's Date of Birth. Format: YYYY-MM-DD Cannot be greater than the current date. | 10 | Date | Required | |
| 6 | lastName | Caregiver’s Last Name. | 30 | String | Required | |
| 7 | firstName | Caregiver’s First Name. | 30 | String | Required | |
| 8 | gender | Caregiver’s Gender. This is an HHAeXchange application requirement. If you do not wish to send this, please default to ‘Other’. Possible Values: Male, Female, Other | 20 | String | Required | |
| 9 | Caregiver’s Email Address. If the value is empty, then the existing value of caregiver’s email address in HHAeXchange is removed | 100 | String | Optional | ||
| 10 | phoneNumber | Caregiver’s Phone Number. Format: 9999999999 If the value is empty, then the existing value of caregiver’s phone number in HHAeXchange is removed | 10 | String | Optional | |
| 11 | type | Caregiver’s Type. Possible Values: Both Select ‘Both’ to reduce conflict rejections in the Visits endpoint when the Procedure Code attribute or skill type is unknown. | 15 | String | Required | |
| 13 | professionalLicenseNumber | Unique ID provided to Caregiver once credentialed by state. If license number is not available, send default value ‘999999999999’. If the value is empty, then the existing value of Professional License Number in HHAeXchange is removed | 50 | String | Required | |
| 14 | hireDate | Date on which caregiver hired by Provider. This is an HHAeXchange application requirement. Providers and EVV vendors should default to sending 1900-01-02 Format: YYYY-MM-DD | 10 | Date | Required | |
| 15 | Address | |||||
| addressLine1 | Individual’s street address. | 100 | String | Optional | ||
| addressLine2 | Individual’s additional street address information if applicable. | 50 | String | Optional | ||
| city | City | 50 | String | Optional | ||
| state | State abbreviation (2 letter state code) e.g. MI | 2 | String | Required | ||
| zipcode | Zip Code (5 or 9-digit format i.e., 12345). Format: 99999 OR 999999999 | 9 | String | Required | ||
When the third party EVV system sends EVV records, the EVV API returns a transaction ID. This transaction ID can be queried by the caller (Vendor/Provider) to get status of the EVV records. Upon successful submission of an EVV record, an EVVMSID (unique visit identifier) is returned along with status. The EVVMSID can be used to update or delete that EVV record in the future. All data sent to HHAeXchange is loaded as-is; there is no data manipulation when processing.
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Third party EVV systems can submit multiple EVV records (new or update) per request. Currently a maximum of 100 EVV records are allowed per request
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Third party EVV systems can submit EVV records from multiple providers.calltype
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If the EVV data does not pass validations, the records are rejected with the appropriate error code and message. The EVV Provider can react by resubmitting corrected EVV records
An option exists for the 3rd party EVV submitter to provide the EVVMSID. The external EVVMSID must be unique across agencies if the 3rd party is sending on behalf of multiple agencies using same Client ID.
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This value must be prefixed with a tilde ("~") sign to differentiate it from the HHAeXchange derived EVVMSID
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The EVV submitter will be responsible to pass a Unique Visit Identifier as the EVVMSID for each new visit created in the system
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When selecting this option use the same EVVMSID with the prefixed tilde when calling the PUT and DELETE endpoints
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Using this option, the HHAeXchange EVVMSID will still be returned in the transactions endpoint and can be used interchangeably.
API consumers must adhere to the following rules:
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Adhere to REST design principles while interacting with the API
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Protocol: secure HTTP (HTTPS)
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Communication Method: Use the appropriate Uniform Resource Identifier (URI) patterns along with HTTP verb (POST, PUT, DELETE, and GET)
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Message Format (Request/Response): application/json
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Produce JSON payloads that meet the API specification
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The API leverages the HTTP response status codes to inform the consumer
POST and PUT Operation
Optional fields are not required. Situational fields are dependent on other fields and may be required as indicated. For example, if a Missed Visit is marked as True, then the Situational fields Missed Visit Reason Code and Missed Visit Action Code are required.
| Index | Element | Description | Max Length | Type | Required? |
|---|---|---|---|---|---|
| 1 | providerTaxID | Provider Tax ID - Unique Identifier for the Provider. Format: 999999999 | 9 | String | Required |
| 2 | Office | ||||
| qualifier |
Value being sent to uniquely identify the member. Possible Values: FederalTaxID, NPI or UMPI
|
50 | String | Required | |
| identifier | Office identifier identified by Office Qualifier. | 64 | String | Required | |
| 3 | Member | ||||
| qualifier | Value being sent to uniquely identify the member. Possible Values: MedicaidID | 50 | String | Required | |
| identifier |
Member identifier identified by Member Qualifier. *Length of this field will be based on the qualifier (For MedicaidID, it will be 50 characters) |
*64 | String | Required | |
| admissionId | Secondary Member identifier. If patient has multiple profiles in HHAeXchange, send both Member qualifier and Admission ID. | 80 | String | Optional | |
| 4 | Caregiver | ||||
| qualifier | Value being sent to unique identify the Caregiver. Possible Values: ExternalID | 50 | String | Required | |
| identifier | Caregiver identifier identified by Caregiver Qualifier. *Length of this field will be based on the qualifier (For ExternalID, it will be 20 characters) | *64 | String | Required | |
| 5 | residingCaregiver |
Possible Values: Yes or No. Required When: If Caregiver is Live-In. |
50 | String | Required |
| 6 | payerID | HHAeXchange assigned ID for the payer. Payer ID is determined during the implementation process. | 50 | String | Required |
| 7 | externalVisitID | Unique Visit identifier in the external system. | 30 | String | Required |
| 8 | evvmsId |
Unique Visit identifier in the HHAeXchange aggregator system. HHAeXchange EVVMSID: Required for updates to the EVV record. External EVVMSID:
|
64 | String | Situational |
| 9 | procedureCode | This is the billable procedure code which would be mapped to the associated service. | 50 | String | Required |
| 10 | procedureModifierCode | Two characters Modifier for the HCPCS code for the 837. Up to 4 of these are allowed. Please consult specific program requirements for exact usage. | 2 | Array of String | Optional |
| 11 | timezone | Time zone visit data is captured in. Required timezone: US/Central All time sent to HHAeXchange from third party provider will be in UTC. Time zone values are based on the Internet Assigned Numbers Authority (IANA) Time Zone Database, which contains data that represents the history of local time for locations around the globe. It is updated periodically to reflect changes made by political bodies to time zone boundaries, UTC offsets, and daylight-saving rules. | 20 | String | Required |
| 12 | scheduleStartTime | Schedule Start Time in UTC Time. Format: YYYY-MM-DDThh:mm If the schedule already exists in HHAeXchange, the Schedule Start Time is overwritten. | DateTime | Required | |
| 13 | scheduleEndTime | Schedule End Time in UTC Time. Format: YYYY-MM-DDThh:mm If the schedule already exists in HHAeXchange, the Schedule Start Time is overwritten | DateTime | Required | |
| 14 | visitStartDateTime |
When Required: When Visit End Date Time OR EVV Clock In Time is provided. Visit Start Time in UTC Time. Format: YYYY-MM-DDThh:mm If a value is provided in this field, then the schedule is confirmed with the start time provided. Cannot be greater than current date. If the value is empty, then the existing value of Visit Start Time in HHAeXchange is removed. If visitStartDateTime/visitEndDateTime and EVV Clock In/Out Time do not match, visit is marked as manually confirmed or adjusted and visit edits should be transmitted. |
DateTime | Situational | |
| 15 | visitEndDateTime |
When Required: When EVV Clock Out Time is provided. Visit End Time in UTC Time. Format: YYYY-MM-DDThh:mm If a value is provided in this field, then the Schedule is confirmed with the End Time provided. Must be greater than Visit Start Date Time. Cannot be greater than current date. If the value is empty, then the existing value of Visit End Time in HHAeXchange is removed. If visitStartDateTime/visitEndDateTime and EVV Clock In/Out Time do not match, visit is marked as manually confirmed or adjusted and visit edits should be transmitted. |
DateTime | Situational | |
| Evv | |||||
| clockIn: When Required: if EVV Clock In Time is confirmed via EVV | |||||
| 1 | callDateTime | When Required: if EVV Clock In Time is confirmed via EVV EVV Clock In Time in UTC Time. Format: YYYY-MM-DDThh:mm If a value is provided in this field, then the Visit Start Time is marked as confirmed via EVV; otherwise, it is considered manually confirmed if visitStartDateTime is provided. | DateTime | Situational | |
| 2 | callType | When Required: if EVV Clock in Time is confirmed via EVV The type of device used to create the event. Values: Telephony, Mobile and FOB. Any call with GPS data collected should be identified as Mobile. If callDateTime is not provided, then API will ignore value in this field. | 20 | String | Situational |
| 3 | callLatitude | When Required: - If EVV Clock in Time is confirmed by GPS (i.e. CallType = Mobile) GPS Latitude recorded during event. Latitude has a range of -90 to 90 with a 6-digit precision. If callDateTime is not provided, then API will ignore value in this field. | Decimal (8,6) | Situational | |
| 4 | callLongitude | When Required: - If EVV Clock In Time is confirmed by GPS (i.e. CallType = Mobile) GPS Longitude recorded during event. Longitude has a range of -180 to 180 with a 6-digit precision. If callDateTime is not provided, then API will ignore value in this field. | Decimal (9,6) | Situational | |
| 5 | originatingPhoneNumber | When Required: - If EVV Clock in Time is confirmed by Telephony (i.e. CallType = Telephony) Originating Phone Number (Caller ID) for telephony. Format: 9999999999 If a value is provided in this field, then it is considered as a Telephony confirmation and this phone number is imported into HHAeXchange. If callDateTime is not provided, then API will ignore value in this field. | 10 | String | Situational |
| 6 | serviceAddress | ||||
| addressLine1 |
The physical address where the EVV check-in took place. If callDateTime is not provided, then API will ignore value in this field. |
100 | String | Situational | |
| addressLine2 |
The physical address where the EVV check-in took place. S If callDateTime is not provided, then API will ignore value in this field. |
50 | String | Optional | |
| city | City If callDateTime is not provided, then API will ignore value in this field. | 50 | String | Situational | |
| state | State abbreviation (2 letter state code). If callDateTime is not provided, then API will ignore value in this field. | 2 | String | Situational | |
| zipcode | Zip Code (5 or 9-digit format i.e., 12345). Format: 99999 OR 999999999 If callDateTime is not provided, then API will ignore value in this field. | 9 | String | Situational | |
| clockOut: When Required: if EVV Clock Out Time is confirmed via EVV | |||||
| 1 | callDateTime |
When Required: if EVV Clock Out Time is confirmed via EVV EVV Clock Out Time in UTC Time. Format: YYYY-MM-DDThh:mm If a value is provided in this field, then the Visit End Time is marked as confirmed via EVV; otherwise, it is considered manually confirmed if visitEndDateTime is provided. |
DateTime | Situational | |
| 2 | callType |
When Required: if EVV Clock Out Time is confirmed via EVV The type of device used to create the event. Values: Telephony, Mobile and FOB. Any call with GPS data collected should be identified as Mobile. If callDateTime is not provided, then API will ignore value in this field. |
20 | String | Situational |
| 3 | callLatitude | When Required: - If EVV Clock in Time is confirmed by GPS (i.e. CallType = Mobile) GPS Latitude recorded during event. Latitude has a range of -90 to 90 with a 6-digit precision. If callDateTime is not provided, then API will ignore value in this field. | Decimal (8,6) | Situational | |
| 4 | callLongitude |
When Required: - If EVV Clock Out Time is confirmed by GPS (i.e., CallType = Mobile) GPS Longitude recorded during event. Longitude has a range of -180 to 180 with a 6-digit precision. If callDateTime is not provided, then API will ignore value in this field. |
Decimal (9,6) | Situational | |
| 5 | originatingPhoneNumber |
When Required: - If EVV Clock Out Time is confirmed by Telephony (i.e., CallType = Telephony) Originating Phone Number (Caller ID) for telephony. Format: 9999999999 If callDateTime is not provided, then API will ignore value in this field. |
10 | String | Situational |
| 6 | performedTasks | List of performed task codes. | Array of String | Optional | |
| 7 | refusedTasks | List of refused task codes. If callDateTime is not provided, then API will ignore value in this field. | Array of String | Optional | |
| 8 | serviceAddress | ||||
| addressLine1 |
The physical address where the EVV check-out took place. If callDateTime is not provided, then API will ignore value in this field. |
100 | String | Situational | |
| addressLine2 |
The physical address where the EVV check-out took place. If callDateTime is not provided, then API will ignore value in this field. |
50 | String | Optional | |
| city |
City If callDateTime is not provided, then API will ignore value in this field. |
50 | String | Situational | |
| state | State abbreviation (2 letter state code). If callDateTime is not provided, then API will ignore value in this field. | 2 | String | Situational | |
| zipcode |
Zip Code (5 or 9-digit format i.e., 12345). Format: 99999 OR 999999999 If callDateTime is not provided, then API will ignore value in this field. |
9 | String | Situational | |
| missedVisit: When Required: When Visit is marked as Missed | |||||
| 1 | missed | When Required: When Visit is marked as Missed Possible Values: True or False An empty value is considered as False. If the value is True, then the Visit is marked as a ‘Missed’ Visit. If False, then the Missed Visit is removed from HHAeXchange if Visit was previously marked as missed and schedule reappears (if the Visit is not yet billed in HHAeXchange). If the Visit is already billed in HHAeXchange, then this flag is ignored. | Boolean | Situational | |
| 2 | reasonCode |
When Required: When Missed Visit = True Missed Visit Reason Code If the value is empty, then the existing value of Reason in HHAeXchange is not removed. If missed flag is not true, then API will ignore value in this field |
4 | String | Situational |
| 3 | actionCode | When Required: When Missed Visit = True Missed Visit Action Code. If the value is empty, then the existing value of Action Taken in HHAeXchange is not removed. If missed flag is not true, then API will ignore value in this field | 4 | String | Situational |
| 4 | notes | Free Text Notes - Data in this field is imported as Visit Notes. Reason/Description of the change being made if entered. If the value is empty, then the existing value of Notes in HHAeXchange is not removed. If missed flag is not true, then API will ignore value in this field | 256 | String | Optional |
| editVisit | |||||
| 1 | edited |
When Required: When Visit is updated after confirmation Possible Values: True or False If the value is True, then the Visit is considered as manually updated. An empty value is considered as False. |
Boolean | Situational | |
| 2 | reasonCode | When Required: When Edit Visit = True Edit Visit Reason Code. If the value is empty, then the existing value of Reason in HHAeXchange is not removed. If edited flag is not true, then API will ignore value in this field. | 4 | String | Situational |
| 3 | actionCode | When Required: When Edit Visit = True Edit Visit Action Code. If the value is empty, then the existing value of Action Taken in HHAeXchange is not removed. If edited flag is not true, then API will ignore value in this field. | 4 | String | Situational |
| 4 | Notes |
Free Text Notes - Data in this field is imported as Visit Notes. Reason/Description of the change being made if entered. If the value is empty, then the existing value of Notes in HHAeXchange is not removed. If edited flag is not true, then API will ignore value in this field. |
256 | String | Optional |
| Billing | |||||
| 1 | externalInvoiceNumber |
When Required: Visit is Billed in the Provider’s third party EVV System If a value is provided in this field, it is considered a Billed Visit in the Provider’s third party EVV System. This invoice number is imported into HHAeXchange, and the Visit is billed in HHAeXchange via the overnight process. If the value is empty, then the existing value of Invoice Number in HHAeXchange is removed. |
18 | String | Situational |
| 2 | totalBilledAmount |
When Required: When Visit is billed; this field should be sent along with externalInvoiceNumber. Total billed amount in third party system. |
Decimal (8,2) | Situational | |
| 3 | totalUnitsBilled |
When Required: When visit is billed; this field should be sent along with externalInvoiceNumber. Total units billed in third party system |
5 | Integer | Situational |
| 4 | contractRate |
When Required: When visit is billed; this field should be sent along with externalInvoiceNumber. Hourly contract rate. |
Decimal (8,2) | Situational | |
| 5 | diagnosisCodes |
When Required: When visit is billed; this field should be sent along with externalInvoiceNumber. Diagnosis Code Up to 26 of these are allowed. |
50 | Array of String | Situational |
| billSecondaryPayer : When Required: When Visit has secondary bill info | |||||
| 1 | enableSecondaryBilling |
When Required: When Visit has secondary billing info. Possible Values: True or False If the value is True, then the Visit is considered to have secondary billing info. An empty value is considered as False. |
Boolean | Optional | |
| 2 | otherSubscriberId |
When Required: When enableSecondaryBilling = true Other Subscriber ID If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
80 | String | Situational |
| 3 | primaryPayerId |
When Required: When enableSecondaryBilling = true Primary Payer ID If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
80 | String | Situational |
| 4 | primaryPayerName |
When Required: When enableSecondaryBilling = true Primary Payer Name If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
60 | String | Situational |
| 5 | relationshipToInsured |
Relationship to Insured If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
2 | String | Situational |
| 6 | primaryPayerPolicyOrGroupNumber |
When Required: When enableSecondaryBilling = true Primary payer policy or Group number If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
3 | String | Situational |
| 7 | primaryPayerProgramName |
Primary Payer Program Name If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
2 | String | Optional |
| 8 | planType |
Plan Type If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
2 | String | Situational |
| 9 | totalPaidAmount |
When Required: When enableSecondaryBilling = true Total Paid Amount If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| 10 | paidDate |
When Required: When enableSecondaryBilling = true Format: YYYY-MM-DD If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Date | Situational | |
| 11 | Deductible |
Deductible If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| 12 | Coinsurance |
Coinsurance. If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| 13 | Copay |
Copay If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| 14 | contractedAdjustments |
Contracted Adjustments If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| 15 | notMedicallyNecessary |
Not Medically Necessary If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| 16 | nonCoveredCharges |
Non-Covered Charges If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| 17 | maxBenefitExhausted |
Max Benefit Exhausted If the value is empty, then the existing value of Reason in HHAeXchange is removed. If enableSecondaryBilling flag is not true, then API will ignore value in this field. |
Decimal (7,2) | Situational | |
| MCO/Payer | Initials | Plan Program |
|---|---|---|
| A&D Home Health Care, Inc. | MI01 | MI CHOICE |
| Aetna Better Health Premier Plan HHCS | MI02 | CHCP |
| Aetna Better Health Premier Plan PCS | MI03 | MI Health Link PCS |
| AmeriHealth - AAA Region 1-A (Detroit) | MI05 | MI Health Link PCS |
| Amerihealth Michigan Inc | MI91 | ICO-MC |
| Area Agency on Aging of Western MI | MI06 | MI CHOICE |
| Area Agency on Aging 1B | MI07 | MI CHOICE |
| Area Agency on Aging Northwest MI | MI08 | MI CHOICE |
| AuSable Valley Community Mental Health | MI09 | Behavioral Health |
| Barry County Community Mental Health | MI10 | Behavioral Health |
| Bay-Arenac Behavioral Health | MI11 | Behavioral Health |
| Blue Cross Complete | MI13 | CHCP |
| CareWell Services/R3BAAA | MI14 | MI CHOICE |
| Centra Wellness | MI38 | Behavioral Health |
| CMH for Central Michigan | MI16 | Behavioral Health |
| CMH of Clinton, Eaton and Ingham Counties | MI15 | Behavioral Health |
| Community Mental Health of Ottawa County | MI59 | Behavioral Health |
| Copper Country Mental Health Services | MI17 | Behavioral Health |
| Detroit Area Agency on Aging | MI18 | MI CHOICE |
| Detroit-Wayne Integrated Health Network | MI19 | Behavioral Health |
| Easterseals/MORC | MI20 | MI CHOICE |
| Genesee Health System | MI21 | Behavioral Health |
| Gogebic Community Mental Health Authority | MI22 | Behavioral Health |
| Gratiot Integrated Health Network | MI23 | Behavioral Health |
| HAP CareSource | MI24 | CHCP |
| HAP CareSource - AAA Region 1-A (Detroit) | MI26 | MI Health Link PCS |
| HAP CareSource - AAA Region 1-B | MI25 | MI Health Link PCS |
| HAP CareSource - The Senior Alliance | MI27 | MI Health Link PCS |
| Hap Empower | MI94 | ICO-MC |
| HealthWest | MI28 | Behavioral Health |
| Hiawatha Behavioral Health | MI29 | Behavioral Health |
| Huron Behavioral Health | MI30 | Behavioral Health |
| Integrated Services of Kalamazoo | MI32 | Behavioral Health |
| Lapeer County Community mental Health | MI33 | Behavioral Health |
| Lenawee Community Mental Health Authority | MI34 | Behavioral Health |
| LifeWays | MI35 | Behavioral Health |
| Livingston County CMH | MI36 | Behavioral Health |
| Macomb County Community Mental Health | MI37 | Behavioral Health |
| McLaren | MI39 | CHCP |
| Meridian | MI40 | CHCP |
| Meridian - AAA 1-A (Detroit) | MI42 | MI Health Link PCS |
| Meridian - AAA Region 1-B | MI43 | MI Health Link PCS |
| Meridian - AAA Region 1-C (TSA) | MI41 | MI Health Link PCS |
| Meridian - AAA Region 3-B | MI44 | MI Health Link PCS |
| Meridian - AAA Region 4 | MI45 | MI Health Link PCS |
| Meridian Health Plan Of Michigan | MI93 | ICO-MC |
| Milestone Senior Services | MI46 | MI CHOICE |
| Molina | MI47 | MI Health Link PCS |
| Molina CHCP | MOCH | CHCP |
| Monroe Community Mental Health Authority | MI48 | Behavioral Health |
| Montcalm Care Network | MI49 | Behavioral Health |
| NEMCSA | MI54 | MI CHOICE |
| Network 180 | MI50 | Behavioral Health |
| Newaygo County Mental Health | MI51 | Behavioral Health |
| North Country Community Mental Health | MI52 | Behavioral Health |
| Northeast Michigan Community Mental Health | MI53 | Behavioral Health |
| Northern Health Care Management | MI55 | MI CHOICE |
| Northern Lakes CMH | MI56 | Behavioral Health |
| Northpointe | MI57 | Behavioral Health |
| Oakland Community Health Network | MI58 | Behavioral Health |
| OnPoint | MI04 | Behavioral Health |
| Pathways Community Mental Health | MI60 | Behavioral Health |
| Pines Behavioral Health | MI61 | Behavioral Health |
| Pivotal | MI71 | Behavioral Health |
| Priority Health Choice | MI62 | CHCP |
| Region IV Area Agency on Aging | MI63 | MI CHOICE |
| Region VII Area Agency on Aging | MI64 | MI CHOICE |
| Reliance Community Care Partners | MI65 | MI CHOICE |
| Riverwood Center | MI12 | Behavioral Health |
| Saginaw County CMHA | MI66 | Behavioral Health |
| Sanilac County Community Mental Health | MI67 | Behavioral Health |
| Senior Resources | MI68 | MI CHOICE |
| Shiawassee Health and Wellness | MI69 | Behavioral Health |
| St. Clair Community Mental Health | MI70 | Behavioral Health |
| State of MI Home Health | MI73 | Home Health |
| State of MI Home Help | MI74 | Home Help |
| Summit Pointe | MI75 | Behavioral Health |
| The Information Center | MI76 | MI CHOICE |
| The Right Door | MI31 | Behavioral Health |
| The Senior Alliance | MI77 | MI CHOICE |
| Tri-County Office on Aging | MI78 | MI CHOICE |
| Tuscola Behavioral Health Systems | MI79 | Behavioral Health |
| United Health Care | MI80 | CHCP |
| UPCAP Services, Inc. | MI81 | MI CHOICE |
| Upper Peninsula Health Plan - UPCAP | MI82 | MI Health Link PCS |
| Upper Peninsula Health Plan | MI83 | CHCP |
| Valley Area Agency on Aging | MI84 | MI CHOICE |
| Van Buren Community Mental Health | MI85 | Behavioral Health |
| Washtenaw County Community Mental Health | MI86 | Behavioral Health |
| WellWise Services/R2AAA | MI87 | MI CHOICE |
| West Michigan Community Mental Health | MI88 | Behavioral Health |
| Woodlands Behavioral Healthcare Network | MI89 | Behavioral Health |
| Code | Description |
|---|---|
| 501 | Confirmed with the member or the member's family member/representative and documented (this service cannot be billed) |
| 502 | New attendant assigned to member (this service cannot be billed) |
| 503 | Other (this service cannot be billed) |
| 504 | Service(s) cancelled or suspended until further notice (this service cannot be billed) |
| 505 | Unverified visit (this service cannot be billed) |
| 506 | Visit rescheduled (this service cannot be billed) |
| Code | Description |
|---|---|
| 600 | Agency unable to provide replacement coverage (no show, no replacement) |
| 601 | Attendant failed to report to client's home |
| 602 | Member requested to change/cancel scheduled visit; or the scheduled visit has been cancelled due to the client's services being suspended |
| 603 | Member Refused Service |
| 604 | Member Refused Service - original aide on vacation |
| 605 | Hospitalization unplanned |
| 606 | COVID-19: All other cases where the agency could not staff due to COVID-19 |
| 607 | COVID-19: Member refused, self-isolating, not receiving service |
| 608 | COVID-19: Member refused, receiving service through informal supports |
| 609 | Other |
| Code | Plan Type |
|---|---|
| BL | Blue Cross/Blue Shield |
| CH | Champus |
| CI | Commercial Insurance Co. |
| MB | Medicare Part B |
| MC | Medicaid |
Service codes for CHCP and Home Health payers (as indicated in the Payer Plan Type column) must have authorizations sent through the authorization interface.
| Procedure Code | Description | Payer |
|---|---|---|
| G0151:0420 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:0421 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:0422 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:0424 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:TS:0420 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0151:TS:0421 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0151:TS:0422 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0151:TS:0424 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:0430 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:0431 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:0432 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:0434 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:TS:0430 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:TS:0431 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:TS:0432 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:TS:0434 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0153:0440 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:0441 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:0442 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:0444 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:TS:0440 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0153:TS:0441 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0153:TS:0442 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0153:TS:0444 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0156:0570 | SERVICES OF HOME HEALTH/HOSPICE AIDE IN HOME HEALTH OR HOSPICE SETTINGS, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0156:0571 | SERVICES OF HOME HEALTH/HOSPICE AIDE IN HOME HEALTH OR HOSPICE SETTINGS, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0156:0572 | SERVICES OF HOME HEALTH/HOSPICE AIDE IN HOME HEALTH OR HOSPICE SETTINGS, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0299:0550 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | State of MI Home Health, CHCP |
| G0299:0551 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | State of MI Home Health, CHCP |
| G0299:0552 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | State of MI Home Health, CHCP |
| G0300:0550 | Direct Skilled Nursing Services Of A Licensed Practical Nurse (Lpn) In The Home Health Or Hospice Setting, Each 15 Minutes | State of MI Home Health, CHCP |
| G0300:0551 | Direct Skilled Nursing Services Of A Licensed Practical Nurse (Lpn) In The Home Health Or Hospice Setting, Each 15 Minutes | State of MI Home Health, CHCP |
| G0300:0552 | Direct Skilled Nursing Services Of A Licensed Practical Nurse (Lpn) In The Home Health Or Hospice Setting, Each 15 Minutes | State of MI Home Health, CHCP |
| H2015 | Community Living Supports (CLS), per 15 minutes | All Behavioral Health Plans, MI Choice, MI Health Link |
| H2015:ES | Community Living Supports (CLS), per 15 minutes 2:1 Aide to Patient | All Behavioral Health Plans |
| H2015:U7 | Community Living Supports (CLS), per 15 minutes, Self-Determination | All Behavioral Health Plans |
| H2015:UJ | Community Living Supports (CLS), per 15 minutes | All Behavioral Health Plans |
| H2015:UN | Community Living Supports (CLS), per 15 minutes, 2 patients served | All Behavioral Health Plans |
| H2015:UN:U7 | Community Living Supports (CLS), per 15 minutes, 2 patients served, Self Determination | All Behavioral Health Plans |
| H2015:UN:UJ | Community Living Supports (CLS), per 15 minutes, 2 patients served, Overnight Health and Safety | All Behavioral Health Plans |
| H2015:UP | Community Living Supports (CLS), per 15 minutes, 3 patients served | All Behavioral Health Plans |
| H2015:UP:U7 | Community Living Supports (CLS), per 15 minutes, 3 patients served, Self Determination | All Behavioral Health Plans |
| H2015:UP:UJ | Community Living Supports (CLS), per 15 minutes, 3 patients served, Overnight Health and Safety | All Behavioral Health Plans |
| H2015:UQ | Community Living Supports (CLS), per 15 minutes, 4 patients served | All Behavioral Health Plans |
| H2015:UQ:U7 | Community Living Supports (CLS), per 15 minutes, 4 patients served, Self Determination | All Behavioral Health Plans |
| H2015:UQ:UJ | Community Living Supports (CLS), per 15 minutes, 4 patients served, Overnight Health and Safety | All Behavioral Health Plans |
| H2015:UR | Community Living Supports (CLS), per 15 minutes, 5 patients served | All Behavioral Health Plans |
| H2015:UR:U7 | Community Living Supports (CLS), per 15 minutes, 5 patients served, Self Determination | All Behavioral Health Plans |
| H2015:UR:UJ | Community Living Supports (CLS), per 15 minutes, 5 patients served, Overnight Health and Safety | All Behavioral Health Plans |
| H2015:US | Community Living Supports (CLS), per 15 minutes, 6 or more patients served | All Behavioral Health Plans |
| H2015:US:U7 | Community Living Supports (CLS), per 15 minutes, 6 or more patients served, Self Determination | All Behavioral Health Plans |
| H2015:US:UJ | Community Living Supports (CLS), per 15 minutes, 6 or more patients served, Overnight Health and Safety | All Behavioral Health Plans |
| S5150 | Unskilled Respite Care, not Hospice, per 15 minutes | MI Choice, MI Health Link |
| T1005 | Respite Care, up to 15 minutes | All Behavioral Health Plans |
| T1005:U7 | Respite Care, up to 15 min for self-determination | All Behavioral Health Plans |
| T1005:UN | Respite Care, up to 15 minutes, 2 patients served | All Behavioral Health Plans |
| T1005:UN:U7 | Respite Care, up to 15 minutes, 2 patients served, Self-Determination | All Behavioral Health Plans |
| T1005:UP | Respite Care, up to 15 minutes, 3 patients served | All Behavioral Health Plans |
| T1005:UP:U7 | Respite Care, up to 15 minutes, 3 patients served, Self-Determination | All Behavioral Health Plans |
| T1005:UQ | Respite Care, up to 15 minutes, 4 patients served | All Behavioral Health Plans |
| T1005:UQ:U7 | Respite Care, up to 15 minutes, 4 patients served, Self-Determination | All Behavioral Health Plans |
| T1005:UR | Respite Care, up to 15 minutes, 5 patients served | All Behavioral Health Plans |
| T1005:UR:U7 | Respite Care, up to 15 minutes, 5 patients served, Self-Determination | All Behavioral Health Plans |
| T1005:US | Respite Care, up to 15 minutes, 6 or more patients served | All Behavioral Health Plans |
| T1005:US:U7 | Respite Care, up to 15 minutes, 6 or more patients served, Self-Determination | All Behavioral Health Plans |
| T1019 | Personal Care Services (PCS), per 15 minutes | MI Health Link |
| T1019:CG | Personal Care Services, per minute under 15 minutes | State of MI Home Help |
| 99601 | Home infusion/specialty drug administration, per 15 minutes (up to 2 hours) | CHCP - limited to certain plans. Only for United Health, Upper Peninsula, BCBS, Priority. |
| 99602 | Home infusion/specialty drug administration, per visit (up to 2 hours); each additional hour (List separately in addition to code for primary procedure) | CHCP - limited to certain plans. Only for United Health, Upper Peninsula, BCBS, Priority. |
| G0151:0420 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:0421 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:0422 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:0424 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0151:TS:0420 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0151:TS:0421 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0151:TS:0422 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0151:TS:0424 | SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:0430 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:0431 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:0432 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:0434 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0152:TS:0430 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:TS:0431 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:TS:0432 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0152:TS:0434 | SERVICES PERFORMED BY A QUALIFIED OCCUPATIONAL THERAPIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0153:0440 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:0441 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:0442 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:0444 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health, CHCP |
| G0153:TS:0440 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| G0153:TS:0441 | SERVICES PERFORMED BY A QUALIFIED SPEECH-LANGUAGE PATHOLOGIST IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES | State of MI Home Health |
| Code | Relationship |
|---|---|
| 01 | Spouse |
| 18 | Self |
| 19 | Child |
| G8 | Other |
| Status | Meaning | Description |
|---|---|---|
| Pending | Request Pending | Request is received at HHAeXchange. Request is yet to be processed |
| Success | Request Success | Request processed successfully and data is also saved into HHAeXchange system |
| Failed | Request Failed | Request processed successfully and data is not saved into HHAeXchange system due to either validation errors or issue at request data. |
| Code | Description |
|---|---|
| 101 | Confirmed visit with the Member or the Member's family member/representative and documented |
| 102 | Confirmed visit with outside entity and documented |
| 103 | New attendant assigned to Member |
| 104 | Visit rescheduled |
| 105 | Service(s) cancelled or suspended until further notice |
| 106 | Updated Member's address and documented |
| 107 | Updated Member's phone number and documented |
| 108 | Changed verification collection method and documented |
| 109 | Timesheet received and signed by supervisor |
| 110 | Mutual Case/ or Cluster Case/ or Live-in Case |
| 111 | Change in schedule |
| 112 | Unverified visit; this service cannot be billed |
| 113 | Supervisor approved change |
| 114 | Timesheet Verified |
| 115 | Other |
| Code | Description |
|---|---|
| 200 | Phone number did not link to the Member |
| 201 | Member won't let attendant use phone |
| 202 | Member doesn't have a phone in home |
| 203 | Phone in use by member or individual in member's home |
| 204 | Member received services outside of the home |
| 205 | Member's phone line not working (technical issue or natural disaster) |
| 206 | Member requested to change/cancel scheduled visit; or the scheduled visit has been cancelled due to the Member's services being suspended |
| 207 | Address did not link to the Member (GPS) |
| 208 | Attendant failed to call in |
| 209 | Attendant failed to call out |
| 210 | Attendant failed to call in and out |
| 211 | Attendant called in to or out of the EVV system early or late |
| 212 | Attendant's identification number (s) does not match the scheduled shift or task discrepancy/task does not match plan of care |
| 213 | Attendant entered invalid fixed location device code(s) |
| 214 | Attendant failed to report to Member's home |
| 215 | Fixed location device on order or pending placement in the home |
| 216 | Fixed location device malfunctioned |
| 217 | Attendant unable to use mobile device |
| 218 | Attendant unable to connect to internet or EVV system down |
| 219 | Data Entry Error |
| 220 | Agency unable to provide replacement coverage (no show, no replacement) |
| 221 | Timesheet Received |
| 222 | Other |