MedicaidAdministrativeHigh impact
School-Based Health Services Timely Filing Change Effective with Dates of Service Beginning July 1, 2023
Illinois Medicaid - HFS·IL · Pediatrics·Provider Notice
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Summary
School-Based Health Services (SBHS) providers in Illinois must now submit claims within 180 days of the date of service, reduced from the previous 18-month timely filing requirement. This change aligns with standard Medicaid provider timely filing policies and is required due to federal CMS reporting deadlines for the new cost-settlement reimbursement methodology.
Action Required
Immediately for dates of service beginning July 1, 2023: SBHS billing teams must update claim submission workflows to ensure all claims are submitted within 180 days of the date of service instead of the previous 18-month deadline. Monitor Document Control Numbers (DCN) to verify HFS receives claims within the 180-day window. Late claims will not meet federal CMS requirements for cost settlement calculations.