MedicaidBilling CodesHigh impact
HIPAA Readiness Update
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Feb 2, 2004
We identified it
Jun 21, 2026
Summary
This HIPAA implementation notice outlines multiple billing format transitions for Illinois Medicaid providers, including pharmacy format changes, local code conversions, and new requirements for HCPCS/CPT codes. Most changes have staggered effective dates between January 1, 2004 and July 1, 2004.
Action Required
By February 2, 2004: Pharmacies must transition from NCPDP Version 3A to NCPDP Version 5.1 format. By April 1, 2004: All providers must convert from state-generated local codes to standard HCPCS/CPT codes and modifiers. DME suppliers must implement new HCPCS codes by January 1, 2004. Billing teams should monitor the Illinois HFS website regularly for updated code conversion tables and testing information.