Provider Notice Issued 04/26/19

​Transportation PowerPoint Presentation for HFS 2270, Physician Certification Statement

This notice informs providers that a PowerPoint presentation has been posted to the Illinois Department of Healthcare and Family Services’ website. This presentation should be used as a reference guide to complete the standardized medical necessity form, HFS 2270 Physician Certification Statement (PCS).

Pursuant to Public Act 100-0646, the Hospital Licensing Act, the Nursing Home Care Act and the Illinois Public Aid Code have been amended to require completion of the PCS for all non-emergency transportation originating at a hospital or LTC facility, via ground ambulance, medicar/wheelchair van or service car transport.This form must be completed prior to transport with a copy provided to the transportation provider at the time of transport. 

This requirement is mandatory for both fee-for-service and managed care clients. Questions regarding this notice or the PCS form may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 or the specific HealthChoice Illinois managed care plan.

Doug Elwell

Medicaid Director