MedicaidAdministrativeHigh impact
Detailed Billing Instructions for Changes to Non-Emergency Ground Ambulance Services for Managed Care Customers Effective January 1, 2022
Illinois Medicaid - HFS·IL · Emergency Medicine, Critical Care·Provider Notice
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Effective January 1, 2022, non-emergency ground ambulance services for Illinois HealthChoice managed care customers must be billed directly to the state Department instead of managed care organizations. Providers must obtain prior authorization through First Transit before providing these services.
Action Required
By January 1, 2022: Billing team must stop submitting non-emergency ambulance claims (codes A0426, A0428, A0433, A0434, A0425, A0422) to HealthChoice Illinois managed care plans and instead bill directly to the Illinois Department. Obtain prior authorization through First Transit (866-503-9040 or Passport system) before providing services. Update billing workflows to reflect this carve-out from managed care. Claims submitted to MCOs after January 1, 2022 will not be paid.