Traditional MedicareAdministrativeMedium impact
Re:
Illinois Medicaid - HFS·IL · Emergency Medicine·Provider Notice
Effective date
Jul 9, 2021
We identified it
Jun 20, 2026
Summary
This notice clarifies transportation billing procedures for dual Medicare-Medicaid beneficiaries in Illinois. For non-emergency transportation, providers must bill Medicare first, then submit secondary claims to managed care organizations. Emergency transportation should be billed to Medicare first, then to the Department as secondary.
Action Required
Immediately: Update billing workflows for dual Medicare-Medicaid patients in Illinois. For non-emergency transportation (codes A0130, A0120), bill Medicare first, then submit secondary claim to MCO. For emergency transportation, bill Medicare first, then submit crossover claim to Illinois Department. Use emergency indicator 'Y' or 'N' when billing A0434 for Specialty Care Transport claims.