MedicaidBilling CodesLow impact
Medication Synchronization
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Aug 8, 2019
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now allows medication synchronization for maintenance medications, enabling patients to pick up all refills in one monthly trip. Pharmacies must use Submission Clarification Code '47' for synchronized medications, which are exempt from patient copayments.
Action Required
Pharmacy billing teams in Illinois: Update billing systems to use Submission Clarification Code '47' when submitting claims for synchronized maintenance medications to Illinois Medicaid. Note that compound drugs, partial fills, and controlled substances are excluded from synchronization eligibility.