MedicaidPrior AuthHigh impact
Update to the Handbook for Home Health Agencies
Illinois Medicaid - HFS·IL · Pediatrics·Provider Notice
Effective date
Sep 1, 2008
We identified it
Jun 21, 2026
Summary
Illinois Medicaid is standardizing prior approval and billing requirements for in-home shift nursing services for children up to age 21, changing from daily to weekly authorization and billing cycles. Services must now be pre-approved and billed on a weekly basis rather than daily, with maximum hours authorized per week instead of per day.
Action Required
By September 1, 2008: Home health agencies must update billing processes to submit claims weekly instead of daily using form HFS 2212 or 837I electronic format. Update prior approval requests (HFS 1409) to include agency workweek information. Bill actual services rendered (e.g., LPN services) even though prior approval issued at RN rate. Claims submitted on daily basis after this date will not align with new weekly authorization structure.