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Ordering/Referring/Prescribing Provider Enrollment and Provider Directory

Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Nov 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

All providers who order, refer, or prescribe for Illinois Medicaid patients must be enrolled with the state and have a valid NPI on claims. Claims with non-enrolled ordering/referring/prescribing providers will be denied starting November 1, 2019.

Action Required

Action needed
Before November 1, 2019: Billing team must verify all ordering, referring, and prescribing providers are enrolled in Illinois Medicaid using the IMPACT Provider Directory. Update billing system to include enrolled provider NPIs on all Medicaid claims. Contact providers at 877-782-5565 if enrollment questions arise. Claims will be denied without proper enrolled provider NPIs.