MedicaidDocumentationHigh impact
Changes to the Face-to-Face Encounter Requirements for the Initial Ordering of Home Health Services; New Face-to-Face Encounter Requirements for the Initial Ordering of Durable Medical Equipment (DME) under the Home Health Benefit
Illinois Medicaid - HFS·IL · Family Medicine, Internal Medicine, General Practice·Provider Notice
Effective date
Jul 1, 2017
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now requires face-to-face encounters for certain durable medical equipment (DME) orders under the home health benefit, with encounters occurring within 6 months of service start. Home health aide services also now require face-to-face encounters with clinical findings documented in the patient's medical record.
Action Required
Immediately: Billing team must verify face-to-face encounter documentation exists for all Illinois Medicaid home health and DME claims before submission. Providers must document face-to-face encounters within 6 months prior to DME delivery and include this certification with all prior approval requests for medical equipment. Update billing workflow to check for face-to-face encounter documentation or claims will be denied.