MedicaidBilling CodesMedium impact
Corrections to Sub-Clinical Behavioral Health Professional Services in Federally Qualified Health Centers and Rural Health Clinics Effective January 1, 2024
Illinois Medicaid - HFS·IL · Psychiatry, Family Medicine, General Practice·Provider Notice
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois has clarified billing requirements for sub-clinical behavioral health professionals in FQHCs and RHCs, changing supervision requirements from 'direct' to 'general' supervision and specifying required modifiers for billing. Claims can now be submitted retroactively to January 1, 2024.
Action Required
Immediately: Update billing system to use procedure code T1040 for all sub-clinical behavioral health professional services with appropriate modifiers: AJ for LCSW supervision, AH for LCP supervision, HO for LCPC/LMFT supervision (no modifier needed for physician/NP supervision). Submit any qualifying claims dating back to January 1, 2024, within 180 days of October 18, 2024. Update encounter forms to capture supervising clinician licensure.