MedicaidBilling CodesHigh impact
DME Supplies to be Billed Through Pharmacy System Effective July 1, 2012
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Summary
Effective July 1, 2012, certain DME supply codes will be removed from the DME Fee Schedule and must be billed through the pharmacy system instead. DME providers who are not enrolled as pharmacy providers will no longer be reimbursed for these supplies after June 30, 2012.
Action Required
By June 30, 2012: DME providers must identify patients with current prior approvals spanning July 1, 2012 for affected supply codes. Review the department's posted document 'DME Supplies Required to be Billed Through the Pharmacy System' to identify specific codes being removed. Ensure patients obtain these items from pharmacy-enrolled providers for dates of service after June 30, 2012. Pharmacy-enrolled providers must rebill rejected DME claims using the item's eleven-digit NDC through the pharmacy billing system. Failure to transition will result in rejection message C16 for claims submitted through DME system after June 30, 2012.