MedicaidAdministrativeHigh impact
Ordering, Referring, Prescribing - National Provider Identifier (NPI) Requirements
Illinois Medicaid - HFS·IL · Physical Therapy, Occupational Therapy, Speech Therapy +5 more·Provider Notice
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
Effective January 1, 2019, all Illinois Medicaid claims requiring an ordering, referring, or prescribing practitioner must include the practitioner's name and National Provider Identifier (NPI), and the practitioner must be enrolled in Illinois Medicaid. Claims missing this information or containing unenrolled practitioners will be rejected and not reimbursed.
Action Required
Before January 1, 2019: Billing team must verify all ordering, referring, and prescribing practitioners are enrolled in Illinois Medicaid through IMPACT system. Update billing system to require practitioner name and NPI on all applicable claims. Verify enrollment status before providing services. Claims will be rejected without proper practitioner information and enrollment.