The AAAHC v44 Standards took effect on 16 December 2025 and put more weight on patient education for informed decisions, data collection and outcomes, patients' cultural and communication preferences, and state scope of practice. The v45 Standards, released on 18 August 2026, apply to surveys on or after 15 December 2026 and add cybersecurity and AI governance.
What AAAHC said v44 changes
AAAHC released v44 on 18 August 2025 with an effective date of 16 December 2025. It named four areas of change. Enhanced education for informed decision-making, stronger guidance for data collection and outcomes measurement, greater sensitivity to patient preferences, cultural needs and expectations, and better alignment with each state's scope-of-practice requirements.1 The update applies to every AAAHC program, including Ambulatory, Medicare Deemed Status, Advanced Orthopaedic Certification and Health Plans.1
AAAHC's own newsletter set out the detail. Patient education so people can make informed health decisions, data practices that better serve patient needs and outcomes, scope of services aligned with patient expectations, respect for personal, cultural and religious beliefs, and support for each patient's preferred communication, including language.23 On scope of practice, the change gives organisations more flexibility to designate qualified practitioners in line with state law and governing body approval.3
| v44 emphasis | What a surveyor is likely to look for | Where it shows in the record |
|---|---|---|
| Education for informed decisions | Patients told about their condition, options, risks and follow-up | The consent discussion and the instructions in the note |
| Data collection and outcomes | Measures tracked over time and used in QI | Reports and QI study data |
| Preferences and culture | Care and information that respect beliefs and preferred communication | Language of messages, and preferences recorded |
| Scope of services | Policies that address who you treat, including children | Policies and patient selection criteria |
| State scope of practice | Practitioners designated in line with state law, approved by the governing body | Privileging decisions and governing body minutes |
Categories, not chapters
Older AAAHC handbooks were organised in chapters. Since v43, the Standards are organised by category, each made of Statements of Requirement with Elements of Compliance, and each assigned a level by risk to patient and staff safety.4 Standards are curated to each organisation from the services in its Application and Profile, so two practices can be surveyed against different sets.4 Categories named by AAAHC under v44 include Patient Rights, Responsibilities, and Protections (PRR), Governance (GOV), Credentialing and Privileging (CPV), Quality (QUA), Clinical Records (CRD), Care Management and Coordination (CMC), Infection Prevention and Control (IPC), Safety (SAF), Emergency Management (EMG), Medication Management (MED) and Facilities and Equipment (FAC). The AAAHC accreditation hub lists the standards in each.
What v45 adds from 15 December 2026
AAAHC released v45 on 18 August 2026 across all programs, effective for surveys on or after 15 December 2026.5 Its main additions are cybersecurity and AI governance standards. They do not require any organisation to use AI. They ask that governance is in place where AI is used, covering governance and oversight, risk management, staff training, patient consent, data security and privacy, and vendor management.6
Most new AI standards start at Level 0, which means no Plan of Correction is required if they are cited and they do not count toward the accreditation decision. Requirements added as Elements of Compliance to existing standards do count.6 Identifiers in v45 may differ from v44.6 v45 policies also move most programs to a 10 calendar day deadline for submitting a Plan of Correction.7
- Confirm your version. Check the Survey Details in 1095 Engage. The version is set when your Application Fee is paid (new organisations) or approved (renewals).
- Download both handbooks. Use the v45 Released Handbook and Self-Assessment Tool in the Help Curtain, marked Not Yet Effective, alongside v44.
- Map v44 identifiers to v45. Use AAAHC's Effective Version Compare document, since identifiers may change.
- List every AI tool in use. Scribes, scheduling, messaging and coding tools. Name an owner, the vendor agreement and how clinicians oversee each one.
- Record patient consent where AI is used. Decide how patients are told and how agreement is recorded.
- Bring it to the governing body. Minute the decisions on AI, cybersecurity and vendors, with the risks considered.
- Tool and vendor ______ Purpose ______
- Clinical or administrative ______ Risk rating ______
- Data it touches ______ Business associate agreement signed on ______
- Human oversight, who reviews the output ______
- How patients are told, and where consent is recorded ______
- Approved by the governing body on ______
What to do before your next survey
- Check your Profile lists every service, so curation is right for whichever version applies.
- Read the patient education and preferences standards against a sample of your own records.
- Bring scope-of-practice decisions to the governing body and minute them.
- Use the AAAHC survey checklist and the mock survey guide to test readiness.
Questions
When did the AAAHC v44 Standards take effect?
16 December 2025. The v44 Ambulatory handbook is no longer effective after 15 December 2026, when v45 applies.
Do the v45 AI standards require us to use AI?
No. AAAHC says they ensure governance is in place where AI is used. Most start at Level 0 and do not count toward the accreditation decision at first.
Does AAAHC still use core and adjunct chapters?
No. Since v43 the Standards are organised by category, with Statements of Requirement and Elements of Compliance, curated to the services each organisation provides.
Which version will my survey use?
New organisations are surveyed against the version current when they pay the Application Fee, renewals against the version current when the Application is approved. 1095 Engage shows it in Survey Details before an onsite survey.
Sources
- 1AAAHC, 2025AAAHC Releases v44 Standards to Drive Excellence in Ambulatory Care (news release)Read source
- 2AAAHC, 2025Prepare for Version 44 Standards, AAAHC newsletter, May 2025Read source
- 3AAAHC, 2025Version 44 Standards Elevate Patient-Centered Care and Clarity, AAAHC newsletter, September 2025Read source
- 4AAAHC, 2024AAAHC Accreditation Handbook for Ambulatory Health Care v43, Client FAQsRead source
- 5AAAHC, 2026AAAHC Releases v45 Standards to Elevate Artificial Intelligence (AI) Governance in Ambulatory Care (news release)Read source
- 6AAAHC, 2026August 2026 Triangle Times Today, AAAHC's New v45 Standards Provide Guidance for Artificial Intelligence UseRead source
- 7AAAHC, 2026v45 Handbook Launch, Client FAQsRead source
Written by the wai team from Accreditation Association for Ambulatory Health Care guidance, checked on 15 October 2026. This is guidance, not legal advice. AAAHC does not endorse wai or any software.