MedicaidCoverageMedium impact
Incontinence Supplies Monthly Limitations
Illinois Medicaid - HFS·IL · General Practice, Family Medicine, Internal Medicine +2 more·Provider Notice
Effective date
May 1, 2014
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has clarified monthly quantity limits for incontinence supplies. Products in Table 1 (briefs, diapers, protective underwear) have a combined limit of 200 units per 30-day period, while Table 2 products (liners, underpads) may be dispensed in addition with their own separate limits.
Action Required
Immediately: DME providers and pharmacies must implement quantity limits for incontinence supplies - limit Table 1 products (T4521-T4534, T4543) to combined total of 200 units per 30-day period. Update billing system to track cumulative quantities across all Table 1 codes. Establish workflow to contact patients before each dispensing to verify continued need and medical eligibility. Claims exceeding limits will be denied.