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MedicaidReimbursementHigh impact

Increased Payment for Primary Care Services

Illinois Medicaid - HFS·IL · Family Medicine, Internal Medicine, Pediatrics·Provider Notice
Effective date
Jan 1, 2013
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois is implementing ACA provisions for increased Medicaid payments to qualified primary care providers for E&M services and vaccine administration from January 1, 2013 through December 31, 2014. Providers must submit attestation forms to receive enhanced Medicare-level reimbursement rates.

Action Required

Action needed
By June 30, 2013: Eligible primary care physicians (family medicine, internal medicine, pediatrics) must complete and submit Form HFS 2352 with attestation documentation to Healthcare & Family Services Provider Participation Unit at P.O. Box 19114, Springfield, Illinois 62794-9114. Board-certified physicians must include copy of current board certification. Non-board-certified physicians must demonstrate 60% of billings are E&M and vaccine codes. Forms received by June 30, 2013 receive retroactive payment to January 1, 2013; later submissions receive payment from receipt date only.

Affected Billing Codes

99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99241
99242
99243
99244
99245
99281
99282
99283
99284
99285
99291
99292
99304
99305
99306
99307
99308
99309
99310
99315
99316
99318
99324
99325
99326
99327
99328
99334
99335
99336
99337
99341
99342
99343
99344
99345
99347
99348
99349
99350
99354
99355
99356
99357
99358
99359
99360
99361
99362
99363
99364
99365
99366
99367
99368
99374
99375
99377
99378
99379
99380
99381
99382
99383
99384
99385
99386
99387
99391
99392
99393
99394
99395
99396
99397
99401
99402
99403
99404
99411
99412
99420
99429
99441
99442
99443
99444
99499
90460
90461
90471
90472
90473
90474