Provider Notice issued 07/07/2026

Coding Update for Behavioral Health Screenings Effective August 1, 2026

This notice informs providers of coding changes to better identify the provision and outcomes of behavioral health screenings. These coding changes apply to claims for customers covered under the Medicaid fee-for-service (FFS) program and the HealthChoice Illinois (HCI) managed care organizations (MCOs).

Claiming for Behavioral Health Screenings

Effective for dates of service on and after August 1, 2026, providers must include one of the following modifiers when billing procedure code 96127 – brief emotional/behavioral assessment:

• Modifier U1 - used to indicate a negative screening result; or
• Modifier U2 - used to indicate a positive screening result and a documented follow-up plan. 

Either the U1 or the U2 modifier must be included on claims for CPT code 96127 or the claim will be rejected. The proprietary error code for FFS claims is L54 / “Missing/Invalid Modifier”.

Providers are to continue billing for depression screens using either G8431 (Depression screening; screening is documented as positive and a follow-up plan is documented) or G8510 (Depression screening; screening is documented as negative, a follow-up plan is not required).

The rate for behavioral health screening codes (96127, G8431, G8510) can be found on the applicable provider's fee schedule. 

Behavioral Health Screenings During Well-Child Visits

In addition, the Department is reinforcing the requirement that behavioral health screenings be offered at all EPSDT required well-child visits. The Department approves the use of any age-appropriate behavioral health screening that is recommended by Bright Futures. Information regarding these recommended behavioral health screenings can be found at Bright Futures Toolkit: Links to Commonly Used Screening Instruments and Tools. 

When a customer has a positive screening result, the provider must document an appropriate follow-up plan based upon the identified needs of the customer. A follow-up plan may include but is not limited to: ongoing monitoring and management by the primary care provider, a referral to a behavioral health clinician within the provider’s organization, or a referral to another behavioral health provider who can offer behavioral health services to meet the customer’s needs.

Behavioral Health Referral Resources

For children under the age of 3 that require additional assessment and services, referrals can be made to the Illinois Department of Early Childhood’s Early Intervention program.  For youth under the age of 21 who need additional behavioral health services, providers may access resources through the Behavioral Health Care and Ongoing Navigation (BEACON Public Portal) may make a referral to the Care Coordination and Support Organization (CCSO) in their area. For other customers who may need additional behavioral health services, providers can locate behavioral health providers in their area.

Questions regarding behavioral health policies and programs may be directed to HFS.BBH@illinois.gov. Questions regarding billing for behavioral health screenings should be directed to a billing consultant with the Bureau of Professional and Ancillary Services at 1-877-782-5565 for FFS claims, or the applicable MCO.

Laura Phelan, Administrator
Division of Medical Programs