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All Kids Health Insurance Program – Cost Sharing

Illinois Medicaid - HFS·IL · Family Medicine, Pediatrics, Chiropractic +4 more·Provider Notice
Effective date
Jul 1, 2006
We identified it
Jun 21, 2026
Days to comply

Summary

Illinois expanded Medicaid coverage under the All Kids program, introducing new co-payment requirements for children in Premium Levels 2-8 based on family income. Co-payments apply to office visits, consultations, psychiatric evaluations, eye exams, and chiropractic treatments, but providers must still collect these from families while the state automatically deducts them from reimbursements.

Action Required

Action needed
Immediately: Billing team must verify All Kids Premium Level for each pediatric patient using MEDI system (www.myhfs.illinois.gov) or calling 1-800-842-1461 to determine co-payment amounts. Update billing workflow to collect co-payments from families for Premium Levels 2-8 while billing usual charges to the state. Do not report co-payment amounts on claims - the state will automatically deduct them from reimbursements.

Affected Billing Codes

99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99241
99242
99243
99244
99245
90801
90802
90804
90805
90806
90807
90808
90809
90810
90811
90862
90863
90865
90870
90875
90876
90880
90882
90885
90887
90889
90899
90901
90911
92002
92004
92012
92014
92015
98940
98941
98942
98943
T1015