MedicaidAdministrativeMedium impact
Fee-for-Service Claim Submittal for Diabetes Prevention and Management Programs
Illinois Medicaid - HFS·IL · Endocrinology, Family Medicine, Internal Medicine·Provider Notice
Effective date
Aug 5, 2024
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has completed system modifications allowing diabetes prevention and management programs to submit fee-for-service claims. Programs can now bill for Diabetes Prevention Program (DPP) and Diabetes Self-Management Education and Support (DSMES) services through standard billing systems.
Action Required
Immediately: Diabetes prevention and management programs must enroll in Illinois HFS' IMPACT system to begin billing. Update billing workflows to submit DPP and DSMES claims via X12 837P transaction or MEDI Internet electronic claim system. Review published billing guidance on Non-Institutional Provider webpage and fee schedule on Medicaid Reimbursement webpage. Previously held claims can be submitted within 180 days with systematic timely filing override.