MedicaidCoverageMedium impact
Buprenorphine for Pregnant Individuals with a Substance Use Disorder Diagnosis
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, Internal Medicine +2 more·Provider Notice
Effective date
Feb 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is increasing the maximum daily buprenorphine dose from 24mg to 32mg for pregnant individuals with substance use disorder, without requiring prior authorization when both pregnancy and SUD diagnoses are documented on the prescription.
Action Required
By February 1, 2024: Billing team and providers must ensure both pregnancy and substance use disorder diagnoses are documented on all buprenorphine prescriptions for pregnant patients to avoid prior authorization requirements for doses up to 32mg daily. Update prescription protocols to include both diagnoses when applicable.