Summary
Illinois Department of Healthcare and Family Services (HFS) now covers medically necessary habilitative services for early-acquired speech-language disorders, including stuttering, for children under age 21 through Medicaid fee-for-service and HealthChoice Illinois managed care organizations. This coverage became effective July 1, 2026, and is mandated by Public Act 104-0528. The policy also confirms that rehabilitative services for stuttering were already covered under prior guidance.
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What to do
Action · 5 steps
01Effective immediately: Billing team and providers must begin accepting and processing claims for medically necessary habilitative speech-language pathology services for stuttering in children under age 21 on Medicaid (both FFS and MCOs).
02Update internal billing guidelines and staff training to reflect that stuttering treatment is now a covered benefit.
03Ensure claims submitted for dates of service on or after July 1, 2026 are processed under the new coverage rules.
04Contact the Bureau of Professional and Ancillary Services at 877-782-5565 or your applicable MCO for specific billing code guidance, as the Chapter J-200 Handbook for Providers of Therapy Services has not yet been updated.
05Do not deny claims for eligible stuttering services for this age group and population based on prior non-coverage.
Original notice
Stuttering Coverage
hfs.illinois.gov · Always check the source before changing claims.