MedicaidBilling CodesHigh impact
Requirement of National Drug Codes (NDC)
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Aug 1, 2005
We identified it
Jun 21, 2026
Summary
Starting August 1, 2005, Illinois Medicaid requires all administered or dispensed drugs to include 11-digit National Drug Codes (NDC) on claims in addition to existing HCPCS codes. This applies to electronic and paper claims but excludes hospital billing (UB92/837I).
Action Required
By August 1, 2005: Billing team must update all claim submission processes to include 11-digit NDC codes for any administered or dispensed drugs while maintaining required HCPCS codes. For electronic claims (837P/MEDI System), follow Chapter 300 Topic 302 guidelines. For paper claims (DPA 2360/DPA 1443), report HCPCS code on one line and NDC on the following service line. Ensure only drugs from CMS Rebate Agreement companies are billed. Claims without proper NDC reporting will not receive appropriate reimbursement.