MedicaidAdministrativeHigh impact
Dental, Optical and Behavioral Health Services Now Covered Through All Managed Care Plans
Illinois Medicaid - HFS·IL · Dentistry, Optometry, Psychiatry·Provider Notice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Summary
Effective July 1, 2014, dental, optical, and behavioral health services for Illinois Medicaid beneficiaries enrolled in MCOs or MCCNs must be billed through their managed care plan instead of directly to the state. Providers must verify patient eligibility and enroll with MCO networks to receive reimbursement for these services.
Action Required
Immediately: Billing team must verify all Illinois Medicaid patient eligibility through REV System, AVRS (1-800-842-1461), or MEDI system before providing dental, optical, or behavioral health services. Stop billing HFS directly for MCO/MCCN enrolled patients for these services - bill the patient's managed care plan instead. Contact local MCOs to begin contracting process if not already enrolled. Claims billed incorrectly will be rejected with R39 or G39 codes.