MedicaidBilling CodesMedium impact
Billing for Screenings Under the Healthy Kids Program
Illinois Medicaid - HFS·IL · Pediatrics, Family Medicine·Provider Notice
Effective date
Feb 10, 2004
We identified it
Jun 21, 2026
Summary
Illinois Healthy Kids Program now requires providers to bill objective screenings (hearing, vision, developmental) separately rather than bundled, and recognizes the AMA's GAPS questionnaire for adolescent risk assessment. Providers must establish usual and customary rates for these unbundled screening services.
Action Required
Immediately: Billing team must establish usual and customary rates for objective hearing, vision, and developmental screenings by unbundling these services from well-child visit rates for Illinois Healthy Kids Program patients. Update billing procedures to bill screenings separately rather than as bundled services. Add GAPS questionnaire as approved screening tool for adolescent patients.