MedicaidAdministrativeHigh impact
UB-04 Fields Required for HFS Processing
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 23, 2007
We identified it
Jun 21, 2026
Summary
Illinois Medicaid (HFS) will not meet the May 23, 2007 deadline for accepting UB-04 claim format. Institutional providers must continue submitting paper claims on UB-92 form and use HFS provider numbers (not NPI) until further notice.
Action Required
Continue using UB-92 paper claim forms for Illinois Medicaid institutional claims instead of transitioning to UB-04. Use HFS provider numbers (not NPI) on all UB-92 forms. Billing teams should maintain current UB-92 workflows and wait for further notification from HFS before implementing UB-04 format.