Back to dashboard
MedicaidBilling CodesHigh impact

Billing Instruction Changes for Observation Services

Illinois Medicaid - HFS·IL · Emergency Medicine, Internal Medicine, Family Medicine +1 more·Provider Notice
Effective date
Jan 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Observation services billing is changing to comply with National Correct Coding Initiative edits. Starting January 1, 2017, providers must bill G0379 with G0378 instead of Evaluation and Management codes (99218-99220, 99234-99236) for observation services.

Action Required

Action needed
By January 1, 2017: Billing team must update billing software to require G0379 with G0378 for all observation services instead of Evaluation and Management codes. Update encounter forms and staff training. Continue using two revenue lines with Revenue Code 0762 for each code. Claims using old coding combinations after January 1, 2017 will be rejected.

Affected Billing Codes

G0378
G0379
99218
99219
99220
99234
99235
99236