MedicaidAdministrativeHigh impact
Preventive Visit Claim Denials
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Nov 10, 2014
We identified it
Jun 20, 2026
Summary
The Illinois Medicaid system incorrectly denied preventive visit claims (CPT 99381-99397) from November 1, 2012 through September 15, 2014 due to overly restrictive visit limits. Providers must re-bill these previously denied claims with error code X11 between November 10, 2014 and May 14, 2015.
Action Required
By May 14, 2015: Billing team must identify and re-submit all preventive visit claims (CPT 99381-99397) that were denied with error code X11 between November 1, 2012 and September 15, 2014. Electronic resubmissions will be automatically processed with time overrides. Paper claims on HFS 2360 forms require manual overrides following instructions on the Non-Institutional Provider Resource webpage. Contact Bureau of Professional and Ancillary Services at 1-877-782-5565 for questions.