MedicaidAdministrativeHigh impact
Billing Change for Non-Emergency Ground Ambulance Services for Managed Care Members Effective January 1, 2022
Illinois Medicaid - HFS·IL · Emergency Medicine·Provider Notice
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Starting January 1, 2022, non-emergency ground ambulance services (Category 051) for HealthChoice Illinois managed care members will be carved out of managed care contracts and must be billed directly to the Illinois Department of Healthcare and Family Services. Providers must obtain prior approval through First Transit before providing these services.
Action Required
By January 1, 2022: Billing team must stop submitting non-emergency ground ambulance Category of Service 051 claims to HealthChoice Illinois managed care plans and begin billing directly to the Illinois Department. Providers must obtain prior approval for all non-emergency ground ambulance services through First Transit before service delivery. Update billing workflows to route these claims to the Department instead of managed care plans. Claims submitted to managed care plans after this date will be denied.