MedicaidBilling CodesHigh impact
Change in Billing for Emergency Ground Ambulance Services for Managed Care Members Effective April 1, 2021
Illinois Medicaid - HFS·IL · Emergency Medicine·Provider Notice
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Summary
Emergency ground ambulance services for HealthChoice Illinois (HCI) managed care members are being carved out from managed care contracts effective April 1, 2021. Claims for emergency ambulance services must now be billed directly to the Illinois Department instead of to the MCO, but MMAI plans continue to cover these services.
Action Required
By April 1, 2021: Billing team must update systems to bill emergency ground ambulance services (codes A0427, A0429, A0433, A0434, A0425, A0422) directly to the Illinois Department instead of HCI managed care plans. Ensure claims include 'Y' indicator for emergency status. MMAI managed care plans should continue to be billed normally for these services.