MedicaidReimbursementHigh impact
Policy Changes Regarding Oxygen and Respiratory Care Services
Illinois Medicaid - HFS·IL · Pulmonology, Sleep Medicine, Critical Care·Provider Notice
Effective date
Jan 1, 2005
We identified it
Jun 21, 2026
Summary
Starting January 1, 2005, Illinois Medicaid changed respiratory equipment reimbursement from rental-only to rent-to-purchase for most items, while ventilators and oxygen concentrators remain rental-only. Equipment becomes patient-owned after 10 months (12 months for apnea monitors), and the state will pay for repairs of purchased equipment.
Action Required
By January 1, 2005: Billing team must update respiratory equipment billing procedures to process rent-to-purchase for specified HCPCS codes instead of rental-only. Update billing system to track 10-month purchase timeline (12 months for apnea monitors E0618/E0619). Continue rental-only billing for ventilators and oxygen concentrators. All new prior approval requests after this date will be reviewed on rent-to-purchase basis.