MedicaidAdministrativeMedium impact
Change to Inpatient Co-payment Assessment Policy and New UB-92 Condition Code
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2003
We identified it
Jun 21, 2026
Summary
Children under 19 are now exempt from inpatient co-payments effective January 1, 2003, except for KidCare programs. Additionally, UB-92 condition code AJ must replace local code 94 for pregnant/postpartum women's co-payment bypass by October 16, 2003.
Action Required
By October 15, 2003: Billing team must update UB-92 forms to use condition code AJ instead of local code 94 for pregnant women and postpartum women (up to 6 weeks) to denote co-payment bypass. Update billing system rules to automatically exempt children under 19 from inpatient co-payments for all programs except KidCare Share and KidCare Premium.