MedicaidDocumentationHigh impact
Local Education Agencies (LEA) Payment Error Rate Measurement (PERM) Audit Findings and Claim Changes
Illinois Medicaid - HFS·IL · Pediatrics, Occupational Therapy, Physical Therapy +1 more·Provider Notice
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
Illinois Medicaid requires Local Education Agencies to maintain comprehensive documentation including IEP records, daily progress notes, and transportation logs to support claims. Beginning January 1, 2018, all ordered/referred services must include individual practitioner NPIs on claims - facility NPIs will no longer be accepted.
Action Required
Before January 1, 2018: LEA billing staff must ensure all claims for ordered/referred services include individual practitioner NPIs rather than facility NPIs. Update billing system to reject claims without individual NPIs. Maintain complete IEP copies, daily progress notes, medication administration records, and transportation logs (U-210.213) for all claimed services. Ordering/referring practitioners must enroll in IMPACT as Individual Rendering/Servicing Providers. Claims will reject without proper individual NPIs.