MedicaidAdministrativeMedium impact
Change in Billing Instructions for COVID-19 Related Long Term Acute Care Hospital Claims for Certain Non-Citizens
Illinois Medicaid - HFS·IL · Critical Care·Provider Notice
Effective date
Oct 13, 2020
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has changed billing instructions for COVID-19 related Long Term Acute Care Hospital claims for certain non-citizens. Instead of electronic processing, providers must now submit paper UB-04 claims directly to the Department with an A88/C88 override request.
Action Required
Immediately: LTAC providers billing for COVID-19 related services for non-citizens ineligible for Medicaid due to immigration status must submit paper UB-04 claim forms with HFS 1624A Override Request Form directly to Illinois Department of Healthcare and Family Services at P.O. Box 19128, Springfield, IL 62794-9128. Include COVID-19 diagnosis code and request A88/C88 override. Claims must be submitted within 180-day timely filing limit.