MedicaidAdministrativeMedium impact
COVID-19 Vaccine Administration Billing for the Illinois Medicaid Pharmacy Benefits Manager System and the Federal HRSA COVID-19 Reimbursement Program for the Uninsured
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Feb 4, 2020
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now allows pharmacy providers to bill for COVID-19 vaccine administration fees through the state's Pharmacy Benefits Management System for Medicaid participants at no cost to patients. Additionally, the federal HRSA program reimburses providers at Medicare rates for COVID-19 services to uninsured patients through a separate claims portal.
Action Required
Immediately: Pharmacy providers in Illinois must update billing procedures to submit COVID-19 vaccine administration claims through the Illinois PBMS for Medicaid patients and through the HRSA COVID-19 Claims Reimbursement Portal for uninsured patients. Ensure no charges are applied to patients for these services. Contact Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service claims questions.