MedicaidBilling CodesHigh impact
Hospital Rate Reform - Additional Guidance Effective with Inpatient Discharges and Outpatient Dates of Service Beginning July 1, 2014
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Summary
Illinois Medicaid implemented major hospital rate reform changes affecting inpatient and outpatient billing, including new NDC requirements for all HCPCS drug codes, mandatory UD modifier reporting for 340B drugs, and updates to discharge status codes and hospital-acquired condition processing.
Action Required
By July 1, 2014: Billing teams must update systems to include NDC codes for all HCPCS drug codes on outpatient claims. Add UD modifier as first modifier for all 340B-purchased drugs. Update observation billing to use Revenue Code 0762 with associated HCPCS codes and add second 0762 line with G0378. Split any series claims that span July 1, 2014 into separate claims. Update discharge status codes to include codes 69 and 81-95. Ensure Present on Admission coding is accurate for HAC evaluation.