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MedicaidBilling CodesMedium impact

UPDATE: New Sections Published under the Comprehensive Billing Manual for Medicaid Managed Care Services

Illinois Medicaid - HFS·IL · Genetics, OB-GYN, Endocrinology +6 more·Provider Notice
Effective date
May 9, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid MCOs released Version 34 of their Comprehensive Billing Manual with multiple updates including new sections for doulas/lactation consultants and behavioral health clinics, coding changes for genetic counseling services, and clarified billing guidance for multiple births and telehealth services.

Action Required

Action needed
Immediately: Review Version 34 of the IAMHP Comprehensive Billing Manual at https://www.iamhp.org/providers. Billing team must update systems to replace procedure code 96040 with 96041 for genetic counseling services. Update telehealth billing to include modifier 93 and POS 10 for diabetes prevention and self-management education services. Review new sections for doulas, lactation consultants, and certified community behavioral health clinics if applicable to your practice.

Affected Billing Codes

96040
96041
93