MedicaidBilling CodesMedium impact
Changes to Current Procedural Terminology (CPT Codes)
Illinois Medicaid - HFS·IL · Family Medicine, OB-GYN, Pediatrics +3 more·Provider Notice
Effective date
Jan 1, 2017
We identified it
Jun 20, 2026
Summary
HFS updated CPT codes for risk assessments effective January 1, 2017. Specific CPT codes (96127, 96160, 96110, 96111) must now be used with appropriate modifiers for different types of screenings including maternal depression, preconception risk, substance abuse, and developmental assessments.
Action Required
Immediately: Billing team must update system to use correct CPT codes for risk assessments - CPT 96127 with HD modifier for postpartum depression screening, CPT 96160 for preconception risk assessments, CPT 96127 for substance abuse screenings, and CPT 96110/96111 for developmental screenings. Update encounter forms and train providers on new coding requirements. Ensure only HFS approved tools are used for assessments.