MedicaidCoverageMedium impact
Pharmacy - Temporary COVID-19 Billing Policies
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Mar 30, 2020
We identified it
Jun 20, 2026
Summary
Illinois HFS has implemented temporary COVID-19 billing policy changes for pharmacies, including relaxed refill timing, extended day supplies for insulin (90 days), temporary OTC coverage for acetaminophen and cough suppressants, and waived signature requirements. These changes are designed to reduce pharmacy visits and promote social distancing during the pandemic.
Action Required
Immediately: Billing team should note that for Illinois Medicaid pharmacy claims, providers can use Submission Clarification Code 420-DK with value 13 for emergency refill overrides, bill up to 90-day insulin supplies, include temporary OTC coverage for acetaminophen and guaifenesin/dextromethorphan cough suppressants, and adjust quantity limits for test strips (300 max) and lancets (400 max). Update billing procedures to reflect waived signature requirements and relaxed prescription limits.