MedicaidCoverageMedium impact
Coverage of Peer Recovery Support Services per Public Act 102-1037
Illinois Medicaid - HFS·IL · Psychiatry, Family Medicine, Internal Medicine·Provider Notice
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois Medicaid will begin covering Peer Recovery Support Services effective October 1, 2024, using HCPCS code H2014 for substance use disorder patients. These nonclinical support services must be provided by certified peer recovery specialists and require physician recommendation with documented medical necessity.
Action Required
By October 1, 2024: Billing team must add HCPCS code H2014 to billing system for Peer Recovery Support Services. Update system to route Illinois Medicaid FFS claims through DARTS portal instead of standard claims processing. Verify provider licensing with IDHS/SUPR before billing. Ensure physician documentation of medical necessity is on file before submitting claims.