MedicaidBilling CodesMedium impact
HIPAA Readiness Update
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Feb 2, 2004
We identified it
Jun 21, 2026
Summary
Illinois Department of Human Services updated HIPAA implementation timelines for Medicaid providers, requiring transition from state-specific local codes to standard HCPCS/CPT codes by April 1, 2004, with pharmacy billing format changes taking effect February 2, 2004.
Action Required
By February 2, 2004: Pharmacies must transition to NCPDP Version 5.1 format only (no longer accepting Version 3A). By April 1, 2004: All providers except DME suppliers must convert from state-generated local codes to standard HCPCS/CPT codes in existing claim formats. Billing teams should monitor the Illinois HFS website regularly for updated code conversion tables and implementation guidance.