Electronic Visit Verification (EVV) in Utah
All states: EVV requirements map
In short: Open model. Agencies choose their own EVV vendor and send visits to Utah Medicaid's own system. Claims are not checked before payment; the state audits afterward.
Utah EVV at a glance
| EVV model | Open (provider choice). Agencies pick and pay for their own EVV software. |
|---|---|
| State EVV system | None. Utah does not provide a visit capture system. |
| Aggregator | Utah Medicaid's own in-house system, Utah Electronic Visit Verification (UEVV) |
| Can I use my own EVV vendor? | Yes. It is the only route. Any system that meets federal rules and Utah's technical specifications is acceptable. |
| Are claims denied without EVV? | No pre-payment EVV check was found. Utah enforces EVV through an annual review after payment, with recoupment. |
| Deadline for EVV records | Within three months of submitting the claim. |
| Managed care | The annual review looks at fee-for-service claims and managed care encounters. |
Last verified against state sources: 2026-10-08.
How does EVV work in Utah?
Utah uses an open EVV model, which the state calls provider choice. There is no state-run EVV app and no required vendor. Each personal care and home health provider selects and pays for its own EVV system, and that system sends visit records to Utah Medicaid's own in-house system, called Utah Electronic Visit Verification (UEVV). Any system that meets the federal requirements and Utah's technical specifications is acceptable.
Records reach the state in one of two ways: a system-to-system connection, or a file upload through the state's secure web portal. The state's EVV FAQ says the file upload method is meant for EVV software vendors and cannot be used as a way to avoid buying an EVV system.
Each record carries the federal data elements (the type of service, who received it, who provided it, the date, the location, and the start and end times) plus the date the electronic record was created. Utah does not require GPS. EVV systems also have to meet federal health privacy and security rules.
Utah does not publish a list of approved or certified EVV vendors, so there is no state list to check a vendor against. Ask any vendor you are considering to show that it meets Utah's technical specifications.
Does Utah deny Medicaid claims without EVV?
No. Utah does not check a claim against EVV records before it pays. The state enforces EVV after the fact, through an annual review, and takes money back when records are missing. So the risk in Utah is not a denied claim this week. It is a recoupment later for visits that were already paid.
Under Utah Administrative Rule R414-522, this is how it works:
- Record deadline: EVV records must be submitted within three months of submitting the claim.
- Annual review: each year the state reviews one randomly chosen month from the prior 12 months for each provider. The review covers fee-for-service claims and managed care encounters.
- Recoupment: the state can recoup up to 25 percent of the amounts paid for EVV-required services in the reviewed month and up to two prior months. If the finding is not remedied, that can rise to as much as 100 percent.
- Withheld payments: the Department may withhold payments from a provider that misses data submission deadlines.
- Relief: a provider can request a good-faith exemption, and a fair hearing is available.
Important: We did not find any state source that describes a pre-payment EVV check on claims, and the rule and the state FAQ describe review after payment only. We could not confirm from public sources whether Utah's claims system has added such a check more recently. If this matters to your cash flow planning, confirm with the Utah Medicaid EVV team.
Because the reviewed month is picked at random, an agency cannot prepare for one month only. Every month has to be complete. The agencies that come through a review cleanly are the ones that check for missing or rejected visit records on a regular schedule, well inside the three-month window, instead of waiting for a notice.
Which services require EVV in Utah?
Utah requires EVV for personal care services and home health services, under the State Plan or a Medicaid waiver, when the service requires an in-home visit. The rule requires an EVV record for personal care from July 1, 2021 and for home health from January 1, 2023. A Utah Medicaid Information Bulletin from September 2023 said penalties for home health would be assessed beginning January 2024.
The state publishes a list of service codes that require EVV. For home care agencies, it includes:
- S5120 (chore), S5130 (homemaker) and S5135 (companion)
- S5125 and S5126
- S5150 and S5151 (respite) and T1005
- T1019 and T1020
- T1021 and S9122 (home health aide)
The list also includes codes used by the Division of Services for People with Disabilities (DSPD). The code list on the state EVV page and the downloadable list dated September 2025 do not fully match, so check your own codes against both. Utah does not publish a waiver-by-waiver list of EVV codes.
Some things are outside EVV in Utah:
- Live-in caregivers: Utah allows an exception for live-in caregivers. The provider agency has to keep the documentation that supports it.
- Medical equipment drop-off: a visit only to deliver medical equipment is an exception.
- Hospice and massage therapy: these do not require EVV.
- T1001: removed from EVV effective July 1, 2023.
For people who direct their own services through DSPD's Self-Administered Services, the DSPD handbook tells employers to follow EVV requirements as directed by their fiscal agent.
What is changing next for Utah EVV?
We did not find any announced change to Utah EVV as of our last check. That includes no announced change of vendor model, no change to the state's in-house system, and no announced move to checking claims against EVV before payment. The rule was last changed on October 26, 2023.
Not finding an announcement is not proof that nothing is planned. The state EVV page carries no last-updated date, and the newest dated EVV document we found is the service code list from September 2025. Watch the Utah Medicaid EVV page and the state's Medicaid Information Bulletins for updates, and ask the EVV team if you have heard of a change that is not posted.
Get notified when Utah EVV rules change
Leave your email and we will let you know when Utah changes its EVV requirements. No newsletter, only changes for this state.
Who to ask about Utah EVV
Questions about Utah EVV rules are best put to the state. Start with Utah Medicaid: Electronic Visit Verification. The state lists dmhf_evv@utah.gov for EVV questions.
Utah EVV sources
- Utah Medicaid: Electronic Visit Verification
- Utah Administrative Rule R414-522: Electronic Visit Verification Requirements
- Utah Medicaid: EVV frequently asked questions (2024)
- Utah Medicaid: LTSS EVV File Technical Specifications v1.7
- Utah Medicaid: EVV service codes (September 2025)
- Utah Medicaid Information Bulletin, September 2023
- Utah DSPD: Self-Administered Services Handbook
Related reading
- EVV Aggregators Explained
- The Benefits of Using 3rd-Party EVV Software
- EVV Software Demo Checklist: What to Ask and Test Before You Buy
- Medicaid Waiver Billing Software: Avoiding Denials in HCBS
- What is EVV Software?
- EVV requirements for every state (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 Utah's requirements, contact Ankota or read more about Ankota's EVV software.
Mr. Nathan Checketts
Utah Department of Health
PO Box 143101
Salt Lake City, UT 84114