MedicaidBilling CodesMedium impact
COVID-19 Vaccine – 2024-2025 National Drug Codes
Illinois Medicaid - HFS·IL · Pharmacy, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Sep 20, 2024
We identified it
Jun 20, 2026
Summary
Illinois has updated billing requirements for 2024-2025 COVID-19 vaccines. Pharmacies billing Medicaid fee-for-service must use 'MA' in the Professional Service Code Field along with the administration fee, while managed care claims require contacting the specific MCO for billing instructions.
Action Required
Immediately: Pharmacies billing Illinois Medicaid fee-for-service for COVID-19 vaccines must update billing systems to include 'MA' in the Professional Service Code Field and identify the administration fee. For managed care claims, contact the applicable MCO at 877-782-5565 for specific rate and billing instructions.