MedicaidBilling CodesHigh impact
Submittal of Claims for Multi-Use Vials
Illinois Medicaid - HFS·IL · Oncology, Rheumatology, Hematology +3 more·Provider Notice
Effective date
Nov 10, 2014
We identified it
Jun 20, 2026
Summary
Providers must now bill only for the actual quantity of drug used from multi-use vials, not the entire vial amount. This change applies to all multi-use medications and was triggered by a federal audit that found inappropriate billing practices for unused portions of vials.
Action Required
Immediately: Billing team must update all claims for multi-use vials to reflect only the actual quantity of medication administered to the patient, not the full vial amount. Review and modify billing software settings to prevent billing for unused portions. Train staff to document exact quantities used. Claims for unused portions are subject to audit and recoupment of payments.