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MedicaidCoverageMedium impact

Blood Pressure Monitoring Kit

Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice +1 more·Provider Notice
Effective date
Jul 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Blood pressure monitoring kits are now a covered benefit for all Medicaid participants, including prenatal and postpartum members, under both managed care and traditional fee-for-service plans. No prior authorization is required for initial equipment orders within specified benefit limits, but replacements before normal limits require prior approval for traditional Medicaid.

Action Required

Action needed
Immediately: Update billing system to recognize HCPCS codes A4660, A4663, and A4670 as covered DME benefits for Medicaid participants with no copayments required. Train billing team on benefit limits (A4660: 1 per 365 days, A4663: 1 per 365 days, A4670: 1 per 1,825 days). For replacements before benefit limits, obtain prior authorization for traditional Medicaid or contact managed care plan for managed care participants.

Affected Billing Codes

A4660
A4663
A4670