MedicaidCoverageMedium impact
Initial Prescription Limit – Changes to Maximum Days’ Supply Effective February 1, 2023
Illinois Medicaid - HFS·IL · Pain Management, Family Medicine, Internal Medicine +3 more·Provider Notice
Effective date
Feb 1, 2023
We identified it
Jun 20, 2026
Summary
Effective February 1, 2023, Illinois Medicaid implemented strict initial prescription limits: maximum 5-day supply for opioids and 14-day supply for benzodiazepines for patients without claims in the past 60 days. After initial fills, standard 30-day supplies are allowed, and prior authorization can bypass limits for chronic conditions like cancer or sickle cell disease.
Action Required
Immediately: Billing team must coordinate with providers to understand Illinois Medicaid opioid and benzodiazepine prescription limits may affect patient visits and prior authorization requests. Update workflows to handle potential increased prior authorization requests for chronic pain patients. Contact 877-782-5565 for FFS claims questions or applicable HCI MCO plans for managed care questions.