MedicaidCoverageMedium impact
Incontinence Supplies Changes
Illinois Medicaid - HFS·IL · Urology, Geriatrics, Pediatrics +1 more·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Summary
HFS is reducing maximum allowable incontinence supplies from 300 to 200 items per 30 days for most products, with liners/pads reduced to 120 per 30 days and small underpads eliminated entirely. Age limits are also being implemented (4-99 years for most codes, 12-99 for bariatric).
Action Required
By July 1, 2012: Update DME billing system to reflect new quantity limits (200/30 days for most incontinence products, 120/30 days for T4535 liners, 150/30 days for T4541 underpads). Remove T4542 small underpads from inventory as this code is eliminated. Implement age restrictions (4-99 years for most codes, 12-99 for T4543 bariatric). Train staff to submit HFS 1409 Prior Approval Request for quantities exceeding new limits when medically necessary.