MedicaidPrior AuthMedium impact
Addition of HCPCS Codes to the Expensive Drugs and Devices (EDD) Listing
Illinois Medicaid - HFS·IL · Hematology, Neurology, General Surgery +2 more·Provider Notice
Effective date
Sep 1, 2010
We identified it
Jun 21, 2026
Summary
Twenty-five new HCPCS codes have been added to the Expensive Drugs and Devices (EDD) listing for outpatient outlier payments, effective September 1, 2010. Three botulinum toxin injection codes (J0585, J0586, J0587) require prior authorization using form HFS 3082.
Action Required
Immediately: Update billing system to require prior authorization for J0585, J0586, and J0587 using HFS 3082 Drug Prior Authorization Request Form. Billing team must ensure these codes are billed in conjunction with appropriate APL procedure codes and include proper NDC reporting. Claims without prior auth for these three codes will be denied.