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Elizabeth M. Whitehorn, Director

Provider Notice issued 08/30/2023

 

Date: August 30, 2023 
​To: All Medical Assistance Program Providers 
​Re: UPDATE: New Sections Published under the Comprehensive Billing Guide for Medicaid Managed Care Services

The Illinois Medicaid Managed Care Organizations (MCOs), in collaboration with the Illinois Association of Medicaid Health Plans (IAMHP), have developed a Comprehensive Billing Guide for Medical Assistance Program providers. This billing guide is designed to help providers who are contracted with the MCOs understand the general MCO billing requirements.

MCOs have different policies and procedures related to billing. With this manual, the MCOs have created a single source of information for all claims regardless of provider type.

As different sections of the Comprehensive Billing Guide are finalized and published, the Department will update providers via a provider notice by listing the new sections. Version 28 of the IAMHP Comprehensive Billing Manual has been released and posted at https://iamhp.net/providers.

Updates in Version 28 include:

· Professional Services - Updated to include information regarding services rendered by Licensed Clinical Professional Counselors (LCPCs) and Licensed Marriage and Family Therapists (LMFTs)

· Dental - Updated Meridian Dental Vendor to Envolve

· New Appendix Added - Appendix L: Third Party Liability and Coordination of Benefits

· Pharmacy Providers - Updated new CountyCare PBM information effective July 1, 2023

· Home and Community-Based (HCBS) Waiver Providers - Updated Aetna Better Health-IL specific guidance when billing T2003 (Adult Day Services transportation)

· Community Behavioral Services - Updated CBS Services tables with new depression screening codes effective with dates of service beginning April 1, 2023

·  Pediatric Services - Updated coding tables with new depression screening codes effective with dates of service beginning April 1, 2023

 

For general questions or feedback regarding the Comprehensive Billing Guide, please contact IAMHP. Questions regarding this notice may be directed to the Bureau of Managed Care at 217-524-7478 or the individual HealthChoice Illinois managed care plan.

 

 

Robert Mendonsa
Deputy Administrator, Care Coordination