MedicaidBilling CodesMedium impact
Hospital Fee-for-Service Billing for Electrocardiograms (ECG) and Visit Codes
Illinois Medicaid - HFS·IL · Cardiology, Internal Medicine, Family Medicine +1 more·Provider Notice
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Summary
Hospitals can now bill the technical component of ECG procedures (tracing only) as fee-for-service in outpatient settings starting July 1, 2016. The professional component must be billed under the practitioner's name/NPI, and global ECG codes should not be used by hospitals.
Action Required
By July 1, 2016: Hospital billing teams must update systems to bill only ECG technical components (tracing only) as fee-for-service. Ensure professional components are billed under practitioner name/NPI. Stop using global ECG codes in hospital outpatient settings. Update billing software rules to prevent inappropriate E&M code billing under hospital NPI (except 99211 with TH modifier for OB triage).