MedicaidPrior AuthMedium impact
Pricing Process for Loaner Items Effective December 1, 2018
Illinois Medicaid - HFS·IL · PM&R (Physical Medicine & Rehab), Orthopedics·Provider Notice
Effective date
Dec 1, 2018
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now requires prior approval using HFS 1409 form for all DME loaner items effective December 1, 2018. Providers must use HCPCS code K0462 with specific modifiers and cannot use Pur/Rent code '5' after November 30, 2018.
Action Required
By November 30, 2018: DME providers must submit HFS 1409 Prior Approval Form for all loaner items using HCPCS code K0462 with modifier 'RR' for electronic claims or Pur/Rent code '2' for paper claims. Update billing system to stop accepting Pur/Rent Code '5' after November 30, 2018. Set Begin Date and End Date periods to cover only one month on requests.