MedicaidAdministrativeHigh impact
HIPAA 5010 Transaction Standards Implementation Timeline
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2012
We identified it
Jun 21, 2026
Summary
Healthcare providers must transition from HIPAA X12 4010A1 to version 5010 electronic billing formats for Medical Assistance claims. Most transaction types are already available, with eligibility requests and payment advice going live January 1, 2012.
Action Required
By January 1, 2012: Billing team must convert electronic billing systems from HIPAA X12 4010A1 to version 5010 format and NCPDP 5.1 to version D.0 for all Medical Assistance claims. Update EDI software to handle new transaction formats for eligibility requests (270/271) and payment advice (835). Contact medical assistance consultant at 1-877-782-5565 for technical support during transition.