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Ankota offers end-to-end solutions for managing care delivery for older or disabled people in their homes and in day facilities. Additionally, some of Ankota's solutions can be unbundled modular components for companies that have home-grown or best of breed components but need additional add on capabilities.

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    Home Care, Day Services and Disability Services will continue to be among the most important industries worldwide for the next 2 to 3 decades. The resources provided here are designed to help you learn and grow. Thanks for being home care heroes and day service stars

      About Us

      Ankota creates software for organizations that keep older and disabled people living at home. Our primary products are software for Home Care, Electronic Visit Verification, Adult Day Services, and Long Term Supports and Services (LTSS) for people with Intellectual and Developmental Disabilities. We also support other players in this ecosystem like PACE programs, Area Agencies on Aging (AAAs), Centers for Independent Living (CILs) and more

          Electronic Visit Verification (EVV) in North Dakota

          Click for the Ultimate Guide to EVV

          Electronic Visit Verification (EVV) in North Dakota

          All states: EVV requirements map

          In short: Open model. Therap is the free state EVV system, and other systems are allowed if they feed the Sandata aggregator. Claims are matched to EVV visits.

          North Dakota EVV at a glance

          EVV modelOpen. Agencies can use the free state system or their own EVV software.
          State EVV systemTherap, contracted by the state and free to providers.
          AggregatorSandata Technologies, live since October 1, 2021.
          Can I use my own EVV vendor?Yes. It must send visit data to the Sandata aggregator, and an agency can use only one EVV system at a time.
          Are claims denied without EVV?Yes. Claims are matched to EVV visits. The state does not publish a date when denials began.
          EVV start datesPersonal care and related services: January 1, 2021. Home health: July 1, 2023.
          Managed careWe did not find EVV rules for Medicaid Expansion through BCBSND. Check with the plan.

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

          How does EVV work in North Dakota?

          North Dakota uses an open EVV model. The state contracts with Therap to provide an EVV system at no charge, and agency providers may use a different EVV system instead as long as it sends visit data to the state aggregator, Sandata Technologies. The aggregator has been live since October 1, 2021 and collects data from every EVV system in the state, including Therap.

          EVV has been required for Medicaid personal care and related home and community based services since January 1, 2021, and for home health services since July 1, 2023. Each visit has to carry the six data elements required by federal law. The current North Dakota EVV policy has an effective date of November 1, 2024 and was last updated in October 2025.

          Some services and settings are outside EVV:

          • Daily-rate live-in personal care has been exempt from EVV since March 1, 2024. Live-in care billed by the unit still requires EVV.
          • Facility settings are excluded: hospitals, nursing facilities, intermediate care facilities for individuals with intellectual disabilities, institutions for mental disease, and congregate residential settings where service is available 24 hours a day.

          Can a North Dakota agency use its own EVV software instead of Therap?

          Yes. Agency providers may use a third-party EVV system if it sends visit data to the Sandata aggregator under the state's alternate vendor specifications. An agency can use only one EVV system at a time, and it must give North Dakota Health and Human Services (HHS) at least three weeks notice before switching to or from Therap.

          A few conditions come with that choice:

          • The provider pays any cost of the interface between its EVV system and the aggregator.
          • HHS states that it is not responsible for claim problems caused by a third-party integration that fails.
          • Agency providers still use Therap to acknowledge service authorizations and to file critical incident reports, even when visits are captured in another system.
          • Home health providers may use their own EVV system if it meets state criteria and is connected to the aggregator. Otherwise they may use the state's system.

          We did not find an official state list of approved or certified third-party EVV vendors. Before you commit to a vendor, ask it to show that it is sending North Dakota visits to the aggregator today. The Sandata North Dakota vendor page holds the technical specifications that vendors build to.

          One exception to plan around: for 1915(i) respite, state policy requires service authorizations and claims to be entered in Therap. We did not find a statement on whether a 1915(i) respite provider can use a different EVV system, so confirm with HHS before assuming you can.

          Does North Dakota deny Medicaid claims without a matching EVV visit?

          Yes. North Dakota ties EVV data to billing, and the state EVV policy says payment may be denied for a claim that has no matching EVV transaction. The state's home health policy says claims submitted without EVV information will be rejected. Neither document gives a date when claim denials began.

          The EVV policy lists two denial codes that agencies should learn to recognize:

          • 16/N281, No EVV Visit Found: there is no EVV visit that matches the claim.
          • 16/N280, Unmatched Units: a visit exists, but the units on the claim do not match it.

          EVV data has to match the claim line and a currently approved service authorization. Several billing details in the policy affect whether that match happens:

          • Overnight shifts must be split at midnight.
          • For services billed in 15-minute units, the first unit needs at least 8 minutes of service.
          • When an exception requires a note, a missing note can lead to denial or recovery of the payment.
          • The aggregator tracks manual corrections. If manual or corrected entries reach 20 percent or more of submitted claims in a review period, the state may treat that as non-compliance.

          The practical point is that a visit delivered but not captured cleanly is at risk twice: once at the claim, and again in a later review of how often your agency edits visits by hand.

          What is changing next for North Dakota EVV?

          We found no announced change to North Dakota's EVV system, its aggregator or its open model as of our last check. Both state policy manuals describe the same Therap and Sandata arrangement that has been in place since 2021. A document labeled as a new EVV policy was posted to the state EVV page in January 2026, and it is the same file as the October 2025 policy manual, so it does not add new rules.

          Important: In a June 2026 bulletin, HHS announced billing changes for Family Home Care and Family Personal Care planned for July 1, 2026, including a new procedure code (T2033 in place of 00001) and billing through Therap or on paper instead of the Medicaid portal. We did not find a later state source confirming that these changes took effect as announced. If you bill these services, confirm the current billing method with HHS.

          That bulletin describes a billing change, not a change to the EVV system, and it concerns services that are largely exempt from EVV. We also did not find published EVV rules for Medicaid Expansion members served through Blue Cross Blue Shield of North Dakota. Sandata publishes a separate technical specification for that plan, so if you serve Expansion members, ask the plan how visit verification and claims work for them.

          Get notified when North Dakota EVV rules change

          Leave your email and we will let you know when North Dakota changes its EVV requirements. No newsletter, only changes for this state.

          Who to ask about North Dakota EVV

          Questions about North Dakota EVV rules are best put to the state. Start with ND Health and Human Services: Electronic Visit Verification (EVV) system.

          North Dakota EVV sources

          Related reading

          Other states that use Therap

          Alaska, Kentucky, South Dakota. 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 North Dakota's requirements, contact Ankota or read more about Ankota's EVV software.

          North-Dakota

          Ms. Caprice Knapp
          North Dakota Department of Human Services
          600 E. Boulevard Avenue, Dept. 325
          Bismarck, ND 58505-0250

          Questions about EVV?

          EVV is still to be implemented in most of the states with different guidelines and regulations. We’re keeping up with the updates related to EVV implementation and if there is something we haven’t included, please share with us. To learn how ankota can help in ensuring compliance, please get in touch with us.

          North Dakota EVV questions

          Who is the EVV vendor in North Dakota?

          North Dakota contracts with Therap to provide a state EVV system at no charge to providers. Agencies are not required to use it. They can use another EVV system as long as it sends visit data to the state aggregator.

          Who is the EVV aggregator in North Dakota?

          Sandata Technologies is the state data aggregator. It has been live since October 1, 2021 and collects visit data from every Electronic Visit Verification system used in the state, including Therap.

          Can I choose my own EVV software in North Dakota?

          Yes. North Dakota is an open model state, so an agency can use a third-party system that sends data to the Sandata aggregator. An agency can use only one EVV system at a time, must give the state at least three weeks notice before switching to or from Therap, and pays any interface costs itself.

          Does North Dakota deny Medicaid claims without EVV?

          Yes. State policy says payment may be denied for a claim with no matching EVV transaction, and the home health policy says claims without EVV information will be rejected. The policy lists denial codes 16/N281 (No EVV Visit Found) and 16/N280 (Unmatched Units). The state does not publish a date when denials began.

          When did EVV start in North Dakota?

          Visit verification has been required for Medicaid personal care and related services since January 1, 2021. For home health services, both state policy manuals give a start date of July 1, 2023.

          Are live-in caregivers exempt from EVV in North Dakota?

          Only in part. Live-in personal care paid at a daily rate has been exempt from EVV since March 1, 2024. Live-in care billed by the unit still has to be captured and verified like any other visit.

          If I use my own EVV system, do I still need Therap in North Dakota?

          Yes, for some tasks. Agency providers that capture visits in a third-party system still use Therap to acknowledge service authorizations and to file critical incident reports.

          How do overnight shifts and short visits work under North Dakota EVV?

          State policy requires overnight shifts to be split at midnight. For services billed in 15-minute units, the first unit needs at least 8 minutes of service. If the units on a claim do not match the verified visit, the claim can be denied as Unmatched Units.

          I need more help with EVV

          Get help with EVV