MedicaidAdministrativeMedium impact
Change in Billing for IDOC and IDJJ
Illinois Medicaid - HFS·IL · Family Medicine, Internal Medicine, General Practice +7 more·Provider Notice
Effective date
May 16, 2011
We identified it
Jun 21, 2026
Summary
Starting May 16, 2011, practitioners treating Illinois Department of Corrections (IDOC) and Illinois Department of Juvenile Justice (IDJJ) inmates must submit claims directly to HFS under their own name and NPI for hospital inpatient, outpatient, and emergency room services. Services not performed in these settings will be denied and must be billed to the IDOC/IDJJ medical vendor instead.
Action Required
Immediately: Update billing procedures to submit IDOC/IDJJ inmate claims directly to HFS under practitioner's name and NPI for hospital inpatient, outpatient, and emergency room services only. Use appropriate Place of Service codes per Handbook Appendix A-10. For office services at hospital-owned offsite clinics within 35 miles, use Place of Service Code 22 for APL procedures and Code 11 for office services (billed to medical vendor). Contact HFS at 217-782-3541 for medical vendor information. Services outside these settings will be denied with Error Code H05.