MedicaidBilling CodesHigh impact
Reporting of the National Drug Code (NDC)
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2008
We identified it
Jun 21, 2026
Summary
Illinois Medicaid now requires providers to report National Drug Code (NDC) along with existing HCPCS codes for all physician-administered or dispensed drugs. This includes specific billing line requirements where NDC must be reported on the service line immediately following the drug HCPCS code.
Action Required
By January 1, 2008: Billing team must update Illinois Medicaid drug billing procedures to include NDC reporting on service line immediately following HCPCS drug codes. For paper claims: bill HCPCS with charge on first line, then NDC with zero charge and container quantity on next line. For multiple NDCs, use modifiers 76 and 51 as specified. Update billing software to handle NDC reporting requirements and prepare for informational messages during 90-day transition period. Failure to report NDC will result in claim rejections starting after transition period.