MedicaidAdministrativeMedium impact
Clarification of Code Definitions in the School Based Health Services Claiming Guide
Illinois Medicaid - HFS·IL · Pediatrics, Family Medicine·Provider Notice
Effective date
Nov 26, 2007
We identified it
Jun 21, 2026
Summary
This notice clarifies activity code definitions for Illinois school-based health services administrative claiming, addressing widespread misunderstanding identified through state monitoring. Local Education Agencies must ensure proper training on distinguishing between medical activities (codes E/F) and educational activities (code I3) for accurate Medicaid reimbursement claims.
Action Required
Illinois school-based health service providers must: 1) Review and update time study training programs to clearly differentiate between medical case management (codes E/F) and educational activities (code I3), 2) Ensure all time study participants understand that educational activities must use code I3, not G1, 3) Implement measures to verify only documented expenditures are submitted for the quarter incurred, 4) Contact Marie VonDeBur at 217-782-3953 for training requests or questions.