Illinois EVV Requirements 2026: A Guide for Home Care Agencies

The first thing to establish in Illinois is which system you are actually in, because there are two and the answer is decided by which program pays for the visit rather than by anything about your agency.

• HFS and HHAeXchange. The Department of Healthcare and Family Services, as the state Medicaid agency, selected HHAeXchange in March 2022 as the state's EVV vendor and aggregator for Medicaid-funded providers throughout Illinois.
• DRS and Sandata. The Department of Human Services Division of Rehabilitation Services is the one waiver program operating its own EVV aggregation system, and it uses Sandata.

If you deliver services across both, you are not running one EVV process with a bit of variation. You are running two, with separate systems, separate rules and separate places the data has to land.

Work this out before evaluating any software. A vendor that connects neatly to one of these may have nothing to say about the other.

HFS puts it about as directly as a state agency ever does: if a provider uses the Department's EVV vendor, HHAeXchange, there is no cost to the provider.

That is worth sitting with before you shop. The state has bought a system, it satisfies the requirement, and using it is a complete answer to EVV compliance in Illinois for the programs it covers. No provider has to purchase anything, and any vendor implying otherwise is describing their commercial interest rather than the rules.

If you choose a different vendor, you pay for that vendor. HFS is equally clear about that side of it: the provider bears the cost of their chosen system.

Illinois permits alternate EVV systems, which makes it an open vendor state in the sense that matters. Two conditions attach.

Your system has to capture the six elements the 21st Century Cures Act requires. And you are required to transmit that data to HHAeXchange for state aggregation. Choosing your own software changes what captures the visit, not where the record has to end up.

The part agencies underestimate is how that transmission works. It happens over Electronic Data Interchange, which means enrolling with HHAeXchange, obtaining credentials and building to their EDI specifications. That is a genuine technical integration with a testing process, not a file you export and email somewhere.

The practical questions to ask any vendor selling into Illinois are therefore quite specific: have you completed EDI integration with HHAeXchange, for how many Illinois agencies, and what happens on my screen when a record is rejected by them rather than merely captured by you.

The DRS side works differently enough to catch people, and one rule inside it lands squarely on small agencies.

DRS individual providers, meaning Personal Assistants and non-agency CNAs, LPNs and RNs, use Sandata directly.

For agencies, DRS requires home health care service and homemaker agencies with fewer than ten employees to secure their own third-party EVV vendor and transmit data to Sandata, rather than using a state-provided system.

Read that carefully, because it inverts the usual expectation. In most states the smallest agencies are the ones most likely to be using the free state system. Under DRS in Illinois, being under ten staff is precisely what obliges you to go and find a vendor of your own.

If you are a small homemaker or home health agency operating under DRS, this is the most important line on the page for you, and it is worth confirming with DRS directly rather than acting on a summary.

Illinois phased this in, and the sequence is straightforward.

• 1 September 2023: personal care services under the Adults with Developmental Disabilities waiver and the Children and Young Adults with Developmental Disabilities waivers.
• 31 December 2023: home health care services for providers serving Medicaid customers.
• 2 March 2026: integration of DRS and Department on Aging provider data.

Personal care services in scope span six waivers: Persons with Disabilities, Brain Injury, HIV/AIDS, Elderly, Adults with Developmental Disabilities, and Children and Young Adults with Developmental Disabilities.

Home health care services in scope include nursing, physical therapy, occupational therapy and speech therapy delivered in the home.

The March 2026 integration is recent enough that guidance around it is still settling. If your work touches DRS or the Department on Aging, check current HFS communications rather than relying on anything written before that date, including this page.

Three questions, in order, will tell you where you stand better than any amount of reading.

• Which program pays for each of your visits? That determines HFS or DRS, and therefore HHAeXchange or Sandata.
• If any of it is DRS, how many employees do you have? Under ten changes your obligation.
• Is the free HHAeXchange system enough for the rest? If your visits sit under HFS and the state system covers them, you have a complete compliance answer at no cost, and the only remaining question is whether anything else is worth paying for on operational grounds rather than compliance ones.

That last distinction is worth keeping clean. Compliance and operations are different problems, and a vendor that blurs them is selling you the first to deliver the second.

This page covers EVV as it applies to home care and home health agencies billing Illinois Medicaid. It does not cover:

• Individual provider arrangements under DRS in detail, including Personal Assistants and non-agency clinical staff
• The Home Services Program policy, which DHS publishes separately
• Department on Aging program rules beyond the March 2026 data integration
• Managed care organization requirements, which sit on top of the state rules
• Billing rates, authorizations or licensure

HFS maintains an Electronic Visit Verification section with provider notices and a frequently asked questions page covering vendor choice, EDI and program scope. That material is authoritative and more current than any third-party summary, this page included.

For DRS questions, including the under ten staff requirement, go to the Department of Human Services Division of Rehabilitation Services rather than to HFS, since DRS sets its own EVV arrangements.

For technical questions about EDI integration or the aggregator, the relevant contact is HHAeXchange for HFS providers, or Sandata for DRS.

Last reviewed 2 August 2026. Illinois integrated DRS and Department on Aging provider data in March 2026, so guidance in this area is still settling. Verify anything that affects a compliance decision directly with HFS or DRS before acting on it. CareVerify is not affiliated with HFS, DRS, HHAeXchange or Sandata.