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System Programming and Claim Submission Updates

Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
May 6, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid resolved multiple behavioral health billing system issues affecting fee-for-service claims from August 2018 forward. Programming fixes now allow previously rejected claims to be resubmitted, and HFS will automatically adjust incorrectly paid add-on amounts for specific procedure codes.

Action Required

Action needed
By August 31, 2019: Behavioral health clinics must rebill H2015 claims with HN and HK modifiers for dates of service August 1, 2018 or later that previously rejected with error codes A59 or C31. Also rebill claims that rejected for H01, R09, or U58 errors related to DHS Social Service eligibility. Verify participant eligibility through MEDI before rebilling. No action needed for H0004, H2010, or Mobile Crisis Response claims as HFS will automatically adjust these.

Affected Billing Codes

H2015
H0004
H2010
S9484