MedicaidCoverageMedium impact
Coverage of Human Donor Breast Milk and Human Milk Fortifiers in the Hospital Inpatient Setting
Illinois Medicaid - HFS·IL · Pediatrics, OB-GYN·Provider Notice
Effective date
Nov 3, 2025
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now covers human donor breast milk and human milk fortifiers for inpatient use without prior authorization. Hospitals must bill using HCPCS code T2101 for processing/distribution or J3590 with revenue codes 0250/0636 depending on contracts.
Action Required
Immediately: Billing teams at participating hospitals must update systems to bill human donor breast milk and fortifiers using HCPCS T2101 (Human Breast Milk Processing, Storage and Distribution) or J3590 (Unclassified Biologics) with revenue codes 0250 or 0636 per contract terms. No prior authorization required for inpatient use.