Electronic Visit Verification (EVV) in Rhode Island

All states: EVV requirements map

Rhode Island EVV at a glance

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

How does EVV work in Rhode Island?

Rhode Island uses an open EVV model with two paths. An agency can use the state-provided system, Sandata Agency Management (SAM) with the Sandata Mobile Connect app, or it can use its own EVV software, which the state calls Alt EVV. Either way, every visit record has to reach the Sandata Aggregator, where the Executive Office of Health and Human Services (EOHHS) reviews it. The EOHHS EVV page is the state's home for forms, specifications and notices.

The state's EVV contractor is Sandata Technologies. State Provider Updates from 2026 refer to the same vendor as HHAeXchange, formerly known as Sandata, so you will see both names in state materials. Providers get a read-only account in the Aggregator to review their own visits.

EVV applies to personal care services and home health care services that require an in-home visit. The state's home and community-based services manual says personal care delivered in an acute hospital has no EVV requirement.

Agencies that choose their own EVV software should know the following:

• The software has to meet the Rhode Island Alternate EVV Specification (version 4.2 at our last check).
• That specification includes a 500-foot geo-fence on GPS log in and log out.
• The agency registers its vendor with the state using an EOHHS form.
• We did not find a published state list of approved alternate EVV vendors, so ask any vendor to show that its Rhode Island interface is in place.

Does Rhode Island deny Medicaid claims without a matching EVV visit?

Yes, for Medicaid fee-for-service claims on four agency home care codes. Since July 7, 2026, the state's claims system checks each of these claims against the Sandata Aggregator. A claim with no matching EVV record suspends for 30 days, and it denies if the EVV data is still missing or wrong at the end of that time.

The four codes named in the state's Provider Updates are:

• T1000: private duty nursing
• S5125: personal care
• S5130: homemaker
• S5125 U1: combined personal care and homemaker

Other details from the state notices:

• A suspended claim shows code ESC 994, 995 or 996.
• The check looks for an EVV record that carries all six federal data elements: the type of service, the person who received it, the date, the location, the person who provided it, and the start and end times.
• The location is expected to be the home, and the log in and log out times are expected to match the time billed.
• Modifiers TV, UH and UJ are not part of the check.
• The check applies to claims that were submitted, adjusted, reprocessed or pending as of July 7, 2026.

An earlier start, announced for dates of service from April 1, 2025, was delayed. The August, September and October 2026 Provider Updates all describe the edits as active.

What do Rhode Island agencies need to get right to stay paid?

The claim has to line up with a complete EVV record in the Aggregator before the 30-day suspension runs out. That makes the Aggregator, not your own software, the record that decides payment on the four checked codes. EOHHS advises providers to review their visits in the Aggregator at least once a week.

• Check the Aggregator, not just your own system. A visit that was delivered but did not arrive complete in the Aggregator is the visit that puts a claim at risk.
• Fix exceptions quickly. A suspended claim gives you 30 days. Agencies that review missing clock ins and clock outs every day rarely get close to that limit.
• Bill the time that was verified. The state expects log in and log out times to match billed time, and the location to be the home.
• Know which payer you are billing. The confirmed check is fee-for-service. Neighborhood Health Plan of Rhode Island requires EVV for personal care and home health services with an in-home visit, but its payment policy does not say what happens to a claim without a matching visit.

A short note for self-direction: the state manual lists personal care code T1019 for people who bill with EVV and S5135 for people who bill without it. T1019 is not on the list of codes checked at the claim, and we did not find a state source saying whether self-directed claims face an EVV claim edit.

What is changing next for Rhode Island EVV?

Two items are pending, and neither has a firm date. Rhode Island is replacing its Medicaid systems under a project called RI Medicaid OASIS, and EOHHS has posted a request for proposals for a new EVV module as part of it. As of our last check, no award, vendor or go-live date had been published. An award could change the state EVV system or the aggregator, but nothing has been announced, so agencies do not need to act on it yet.

Separately, EOHHS has said it plans to replace the state-only skilled home health code X0043 with 15-minute codes (G0299 with modifier UD, and G0300) in both the claims system and the EVV system. The state has described December 2026 as a target and has said an exact date will follow. Treat that timing as not final until the state confirms it.

We did not find an announced date for managed care plans to begin checking claims against EVV, or an announced plan to add more codes to the fee-for-service check.

Rhode Island EVV sources

• RI EOHHS: Electronic Visit Verification (EVV)
• RI Medicaid Provider Update 405 (October 2026)
• RI Medicaid Provider Update 403 (August 2026)
• RI Medicaid Provider Update 402 (July 2026)
• RI EOHHS: EVV subregulatory guidance (February 27, 2024)
• Rhode Island Alternate EVV Specification, version 4.2
• RI Medicaid HCBS provider manual, version 1.12 (December 2024)
• Neighborhood Health Plan of Rhode Island: Home Health Agency Services payment policy (January 1, 2026)
• RI EOHHS: RI Medicaid OASIS

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
• Field guide: The Omit-and-Resubmit Method for Sandata
• Medicaid Waiver Billing Software: Avoiding Denials in HCBS
• EVV requirements for every state (map)

Other states that use Sandata

California, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Indiana, Maine, Massachusetts, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, 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 Rhode Island's requirements, contact Ankota or read more about Ankota's EVV software.