MedicaidDocumentationMedium impact
Physician Certification Statement for All Non-Emergency Transportation
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Nov 1, 2018
We identified it
Jun 20, 2026
Summary
Illinois requires a new standardized form (HFS 2270 Physician Certification Statement) for all non-emergency transportation services including ambulance, wheelchair van, and service car transports, replacing previous MCA and CTS forms. The form must be completed prior to transport and provided to the transportation provider.
Action Required
By February 1, 2019: Develop internal policy requiring physicians to complete HFS 2270 Physician Certification Statement form for all non-emergency transportation. Maintain copies in patient medical records. Ensure form is completed prior to transport and provided to transportation providers. If incomplete, provide completed form within 10 calendar days at no charge to avoid claim denials.