Electronic Visit Verification (EVV) in Hawaii

All states: EVV requirements map

Hawaii EVV at a glance

Last verified against state sources: 2026-10-08.

How does EVV work in Hawaii?

Hawaii uses an open EVV model for provider agencies. The Med-QUEST Division supplies a Sandata EVV system at no cost, and an agency may instead use an alternate EVV system at its own cost. Either way, every visit ends up in the Sandata Aggregator, which is where claims are checked. Use of EVV has been mandatory statewide since December 30, 2020, after a soft launch that ran from October 5 to December 29, 2020.

An alternate EVV system has to meet the state's technical specifications and business rules and complete certification with Sandata before it is used in production. The Med-QUEST EVV FAQ explains the choice. We did not find a published list of alternate EVV vendors certified for Hawaii, so ask any vendor you are considering to confirm its Hawaii certification status.

The choice applies to provider agencies only. Self-direct and consumer-directed members and their workers must use the Sandata system.

The state no longer hands out smartphones for EVV. Med-QUEST stopped offering vendor-issued smartphones beginning October 1, 2025, so caregivers on the state system capture visits another way, such as an app on a personal or company device, a landline, or a fixed device (FOB).

Does Hawaii deny Medicaid claims without a verified EVV visit?

Yes. Since October 1, 2021, the health plans and the Developmental Disabilities Division (DDD) do not pay a claim for an EVV service when there is no matching visit in Sandata. The state's current code memo, dated February 6, 2026, restates the rule: a claim for an EVV service must be verified against an EVV visit in the Sandata Aggregator before it is paid.

Med-QUEST provider bulletins describe two denial edits:

• L226.1: no visit found for the claim line.
• L227.1: unmatched units, meaning the claim bills more units than the EVV system holds.

Units count only for visits in Verified, Approved or Processed status. Validation uses the quantity on the claim line. For services billed in 15-minute units, Hawaii applies a 7-minute buffer, and units are worked out for each visit and then added together. Home health agency services are captured as one visit per day, billed with a quantity of 1.

Claim line rules differ by payer. Ohana and Kaiser allow one member, one service and one day per claim line. The other payers accept span billing of up to 31 days on a line.

If an EVV problem is blocking payment, the state's guidance is to take it to the payer first and then to Med-QUEST if it is not resolved after two weeks. Agencies should not stop services over an EVV issue.

What else do Hawaii agencies need to get right?

The main thing is the 15 percent rule. No more than 15 percent of a provider's visits in a month may be manually edited or manually entered, measured for each provider ID. Since April 1, 2024, an agency that stays above that limit can have 15 percent of its payments withheld. The rule is set out in memo QI-2305C.

• Alternate EVV counts too. The 15 percent measure also covers visits captured by an alternate EVV system.
• Withholding exclusions are discretionary. A health plan or DDD may grant one on evidence such as vendor ticket numbers, so keep a record of every system issue you report.
• Licensed settings are out of scope. Personal care delivered in licensed or certified settings is not subject to EVV. The memo lists DD Adult Foster Homes, Community Care Foster Family Homes, DD Domiciliary Homes, ARCH and E-ARCH homes, and Therapeutic Living Programs licensed as Special Treatment Facilities.
• Check the current code list. Memo QI-2605 (February 6, 2026) replaced the 2021 memo QI-2125. It takes three in-home therapy code and modifier combinations (physical, speech and occupational therapy) out of EVV and adds five personal care combinations for agencies that use the neighborhood model of care. Home health and personal care services stay on EVV. Read the memo's appendix for the exact codes and modifiers.

The Med-QUEST EVV web page still links some older memos, so use the provider memo index to confirm which memo is current. For I/DD waiver providers, DDD measures compliance separately from the health plans, and EVV applies to chore, personal assistance and habilitation, respite and private duty nursing.

A low manual edit rate comes from visits being captured correctly at the time of service. Agencies that review exceptions every day, instead of at billing time, tend to stay well under the limit.

What is changing next for Hawaii EVV?

Nothing about the re-procurement changes what agencies must do today. Sandata remains the state EVV system and the aggregator, and the state's February 2026 memo still names the Sandata Aggregator as the place where claims are verified. If the state system does change in the future, agencies on the free state system and self-direct users would be affected most directly, so it is worth watching the Med-QUEST provider memo index.

One other item is still open. The state has said a payment withhold for self-direct and consumer-directed accounts that exceed the 15 percent manual edit limit will be set at a future date. As of our last check, we did not find a memo that sets that date.

We found no other upcoming EVV change with a firm effective date.

Hawaii EVV sources

• Med-QUEST Division: Electronic Visit Verification
• Med-QUEST Division: EVV frequently asked questions
• Med-QUEST memo QI-2605: EVV service codes and modifiers (February 6, 2026)
• Med-QUEST memo QI-2520: EVV vendor-issued smartphone devices (October 8, 2025)
• Med-QUEST memo QI-2305C: EVV manual editing and entry of visits (August 15, 2024)
• Med-QUEST Division: Hawaii alternate EVV overview
• Med-QUEST Provider Bulletin, June 2024
• Med-QUEST Provider Bulletin, September 2024
• Med-QUEST Division: provider memo index

Related reading

• EVV Software Compatible with Sandata Aggregator
• EVV Aggregators Explained: A Simple Guide for Home Care Providers
• The Benefits of Using 3rd-Party EVV Software
• EVV Software Demo Checklist: What to Ask and Test Before You Buy
• What is EVV Software?
• EVV requirements for every state (map)

Other states that use Sandata

California, Colorado, Connecticut, Delaware, District of Columbia, Idaho, Indiana, Maine, Massachusetts, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Wisconsin. See every state on the EVV requirements map.

Page history

• October 8, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides EVV software for Medicaid home care agencies. If you would like to talk through Hawaii's requirements, contact Ankota or read more about Ankota's EVV software.