Traditional MedicareBilling CodesMedium impact
Reimbursement Clarification for Participants Covered under Managed Long Term Services and Supports (MLTSS)
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Feb 2, 2021
We identified it
Jun 20, 2026
Summary
This policy clarifies that for MLTSS participants, Medicare cost-sharing for non-emergency transportation (ambulance, taxi, service car, etc.) should be billed to HealthChoice Illinois managed care plans after Medicare adjudication, while emergency transportation cost-sharing should be billed to the Department.
Action Required
Immediately: Transportation providers must update billing workflows to bill Medicare cost-sharing for non-emergency transportation services (codes 051-056) to HealthChoice Illinois managed care plans after Medicare processes claims. Bill emergency transportation cost-sharing directly to the Illinois Department. Ensure all providers are enrolled with Illinois Medicaid via IMPACT system.