EVV in Hawaii: Aggregator, Approved Vendors, Reason Codes and Deadlines (2026)

Hawaii Medicaid EVV explained for home care agencies: the Sandata state system, open model, how alternate vendors certify, which services need EVV, key dates, reason codes and how to fix a denied claim.

November 5, 2026

Short answer. Hawaii’s Med-QUEST Division uses Sandata as its EVV system and pays for it. Agencies may use an alternate EVV vendor at their own cost if it is certified with Sandata. EVV covers home health and personal assistance services, and claims without EVV are denied. Check a visit before billing with the EVV visit checker.

At a glance

Topic	Details
Aggregator	Sandata, the Med-QUEST EVV system
Model	Open: the state Sandata system or a certified alternate vendor
State system	Sandata EVV, paid for by Med-QUEST
Alternate vendors	Allowed at the agency’s cost; each provider and vendor pair certifies with Sandata
Services that require EVV	Home health (skilled nursing, therapy, home health aide) and home care personal assistance, through Med-QUEST and the QUEST Integration health plans
Key dates	EVV mandatory since December 30, 2020; payment withholds for non-compliant providers began April 1, 2024
Who to call	Med-QUEST EVV; Sandata Hawaii customer care; your health plan

Which vendors are approved in Hawaii?

Med-QUEST pays for the Sandata system, including training and ongoing fees. An agency can use an alternate EVV vendor instead, at its own cost. Each provider and vendor combination has to complete Sandata’s certification and upload visits to the Sandata aggregator using its technical specification. Confirm your vendor has finished certification before you rely on it for Medicaid visits.

Open or closed model, and what it means for you

Open: caregivers clock in and out in Sandata or a certified alternate system, the visit goes to Sandata, and the health plan matches the claim against it. If Sandata never receives an accepted visit, the claim denies.

The six elements every visit must carry

Type of service, individual receiving the service, individual providing the service, date, location, and start and end time. Missing any one is a rejected visit. The usual failures: a missing clock-out, a caregiver not linked to the agency on that date, and a check-in away from the home with no reason recorded.

Rounding and units

Personal care is usually billed in 15-minute units. Hawaii’s fee schedule and provider manual set the unit and the rounding rule for each service code, so check them for the codes you bill. Convert minutes with the units calculator.

Reason codes

Hawaii’s exact reason codes and their wording are set in Sandata EVV. These are the kinds of reasons it asks for:

Reason	When to use it
Missed clock-in or clock-out	The caregiver forgot to check in or out; the visit is entered manually
Device or app problem	Phone, app or battery failed during the visit
No signal at the home	Location could not be captured
Member refused or unavailable	The member would not use the phone or device
Service in the community	The visit took place away from the home
System outage	A confirmed outage of the state or vendor EVV system

Use the most specific reason. Payers audit free-text “Other” and repeated manual entries by the same caregiver.

Grace window

We did not find a set grace period for late clock-ins in Hawaii’s EVV guidance. Small differences from the schedule usually pass; the EVV visit checker flags visits more than 15 minutes off schedule so you can add a reason first. Your health plan contract may set a tighter threshold.

Deadlines and the correction window

EVV has been mandatory since December 30, 2020, and Med-QUEST began payment withholds for non-compliant providers on April 1, 2024. Correct the visit in your EVV system, confirm Sandata accepts it, then resubmit the claim to the health plan. Check your health plan’s timely filing limit.

If a claim denies for EVV

Find the visit in your EVV system and read the rejection reason.
Fix the element (member ID, service code, times, location) and attach the reason code.
Confirm the aggregator shows the visit as accepted or verified.
Resubmit the claim. Do not resubmit before step 3; it denies again.

How Caregiver Scheduling handles Hawaii EVV

Caregiver Scheduling captures the six elements with geofenced GPS check-in, logs an override reason when GPS can’t confirm the location, and flags late and missed check-ins for the office. In Hawaii, a visit counts for Medicaid only once it reaches Sandata from the state system or a certified alternate, so ask us how that works for your agency. GPS check-in and EVV.

Sources

Last reviewed November 6, 2026. General information, not legal or billing advice; confirm current rules with Hawaii’s Medicaid agency.