MedicaidPrior AuthHigh impact
New Therapy Prior Approval Form
Illinois Medicaid - HFS·IL · Physical Therapy, Occupational Therapy, Speech Therapy·Provider Notice
Effective date
Aug 18, 2014
We identified it
Jun 20, 2026
Summary
Illinois HFS has introduced a new dedicated Therapy Prior Approval Request Form (HFS 3701T) that must be used for all physical, occupational, and speech therapy services requiring prior approval. The old general prior approval form (HFS 1409) is no longer acceptable for therapy services.
Action Required
Immediately: Billing team must begin using the new HFS 3701T Therapy Prior Approval Request Form for all physical, occupational, and speech therapy services requiring prior approval. Stop using the HFS 1409 Prior Approval Request form for therapy services. Download the PDF-fillable form from the Illinois HFS Medical Programs Forms page. Note: This does not apply to home health agency therapy services.