MedicaidAdministrativeMedium impact
Chapter H-200, Handbook for Hospital Services
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Oct 1, 2011
We identified it
Jun 21, 2026
Summary
Illinois Medicaid updated hospital billing rules for MCO patients whose coverage begins or ends during inpatient stays - the covering entity at admission is now responsible for the entire stay. Additional updates include fee-for-service billing changes for corrections inmates and correction of condition codes.
Action Required
Immediately: Update billing procedures for Illinois Medicaid MCO patients - bill the covering entity at time of admission for entire inpatient stay, regardless of coverage changes during stay. Update fee-for-service billing procedures for IDOC/IDJJ inmates effective May 16, 2011. Correct Condition Code references from '4' to '04' and add Revenue Code 0948 to non-covered listings.