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MedicaidBilling CodesMedium impact

Monkeypox Testing and Vaccine Administration

Illinois Medicaid - HFS·IL · Infectious Disease, Family Medicine, Internal Medicine +2 more·Provider Notice
Effective date
Jul 26, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois establishes billing guidelines for monkeypox testing using CPT code 87593 at a Medicaid rate of $30.79, effective July 26, 2022. Monkeypox vaccines are provided free from the federal government with no separate administration fees - only minimal office visit charges when vaccination is the sole purpose of visit.

Action Required

Action needed
Immediately: Update billing system to use CPT code 87593 for monkeypox virus testing at $30.79 for Illinois Medicaid patients. Do not bill for monkeypox vaccine costs (free from federal government). For vaccination-only visits, bill minimal office visit CPT code instead of separate administration fees. Update encounter forms to reflect these billing rules.

Affected Billing Codes

87593