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Enrollment in the Health Benefits for Immigrant Adults (HBIA) program will be temporarily paused effective July 1, 2023.

Enrollment in the Health Benefits for Immigrant Seniors (HBIS) program will be temporarily paused effective Nov. 6, 2023.

Provider Notice Issued 07/27/2022

Date:    July 27, 2022      

To:       Enrolled Physicians, Advanced Practice Nurses, Physician Assistants, Local Health Departments, Encounter Rate Clinics, Federally Qualified Health Centers, Rural Health Clinics, and Hospitals

Re:      COVID-19 Vaccine Counseling Coverage Updates


This notice provides updates regarding coverage for COVID-19 vaccination counseling. These updates apply to claims for participants covered under both traditional Medicaid fee-for-service (FFS) and the HealthChoice Illinois (HCI) managed care organization (MCO) plans.

HFS initially identified coverage for COVID-19 vaccination counseling in a
provider notice dated November 18, 2021. Below are updates to that coverage:

  • Effective October 29, 2021, the age range for Procedure Code 99402 - Preventive medicine counseling and/or risk factor intervention/s provided to an individual (separate procedure); approximately 30 minutes, has been expanded from ages 5 through 17 years to ages 5 through 20 years. 
  • Effective October 29, 2021, Procedure Code 99402 will not be tied to the child receiving the vaccination. It may be billed separately regardless of the child receiving the vaccination.  
  • Effective June 17, 2022, the age range for Procedure Code 99402 has been lowered to 6 months through 20 years. 

The Department's COVID-19 Fee Schedule has been updated. Questions regarding this notice may be directed to a billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims, or the applicable HCI MCO plan.

Kelly Cunningham, Administrator
Division of Medical Programs