MedicaidPrior AuthMedium impact
New Prior Approval Requirements for Wheelchair Providers
Illinois Medicaid - HFS·IL · PM&R (Physical Medicine & Rehab), Neurology, Orthopedics·Provider Notice
Effective date
Jun 1, 2018
We identified it
Jun 20, 2026
Summary
New prior approval requirements for wheelchair providers take effect June 1, 2018, requiring distinct HCPCS codes and descriptions for all wheelchair components on Form HFS1409. Providers must use specific HCPCS codes rather than the generic K0108 code except when no specific code exists.
Action Required
By June 1, 2018: Billing team must update wheelchair prior authorization requests to use distinct HCPCS codes for all custom manual/power wheelchair and POV components on Form HFS1409. Stop using K0108 (Wheelchair Accessories, Not Otherwise Specified) except when no specific HCPCS code exists. May require submitting multiple HFS1409 forms per request. Use distinct HCPCS codes when billing repairs under $400 that don't require prior approval.