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MedicaidReimbursementMedium impact

HFS Procedure for Rate Determination and Claim Processing as New COVID-19 Testing Codes are Released

Illinois Medicaid - HFS·IL · Pathology, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Dec 8, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois HFS will add new COVID-19 laboratory testing codes to their database as released by CMS, but claims with these codes will suspend until Medicare or NGS assigns rates. Once rates are assigned, suspended claims will be released for processing.

Action Required

Action needed
Monitor the COVID-19 fee schedule on the HFS COVID-19 Updates webpage for new testing codes and rates. Expect claims with new COVID-19 lab codes to suspend until rates are assigned by Medicare/NGS. Contact Bureau of Professional and Ancillary Services at 877-782-5565 with questions about suspended claims.