Molina Healthcare Illinois policies, page 10

Search Molina Healthcare Illinois's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

683 public policies Substrate tracks for Molina Healthcare Illinois, by title.

Molina Healthcare Illinois policies
PolicyDetailsCodesSource
Packaged and conditionally packaged lab servicesCommercial—Original policy ↗
Packaged and conditionally packaged lab servicesMedicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, WA, WI—Original policy ↗
Packaged and conditionally packaged lab servicesMedicaid · IL—Original policy ↗
Paid Amount Exceeded Billed AmountEffective Jul 30, 2025 · Commercial, Medicaid—Original policy ↗
Palynziq (pegvaliase-pqpz) MHIMedicaid · IL, MS—Original policy ↗
Pancreas TransplantationEffective Apr 23, 2021 · Commercial, Medicaid20Original policy ↗
Papzimeos (zopapogene imadenovec)Commercial, Medicaid1Original policy ↗
Papzimeos (zopapogene imadenovec) MEDICARE1Original policy ↗
Parsabiv (etelcalcetide) MHIMedicaid · IL, MS1Original policy ↗
PCSK9 Inhibitors MHIMedicaid · IL, MS—Original policy ↗
Percutaneous Electrical Nerve Field Stimulation for Abdominal PainCommercial4Original policy ↗
Percutaneous Epidural Adhesiolysis257 · Commercial2Original policy ↗
Percutaneous Image-Guided Lumbar Decompression (PILD) for Lumbar Spinal StenosisCommercial4Original policy ↗
Percutaneous Ventricular Assist Devices132 · Commercial, Medicaid6Original policy ↗
Perirectal Spacer for Prostate Radiotherapy425 · Commercial1Original policy ↗
Permethrin Molina IL Medicaid Only C30302-AC30302-A · Medicaid · IL—Original policy ↗
Peroral Endoscopic Myotomy for Esophageal Achalasia385 · Commercial, Medicaid2Original policy ↗
Phototherapy, Photochemotherapy, and Laser Therapy for Dermatological Conditions292 · Commercial, Medicaid12Original policy ↗
Physician Office Laboratory TestingCommercial, Medicaid60Original policy ↗
Physician Office Laboratory TestingMedicaid211Original policy ↗
Physician Office Laboratory TestingMedicaid · AZ, CA, FL, IA, ID, IL, MA, NE, NM, NY, OH, SC, TX, WA, WI60Original policy ↗
Plantar Fasciitis SurgeryCommercial, Medicaid6Original policy ↗
Plantar Fasciitis Treatments338 · Commercial, Medicaid37Original policy ↗
Platelet-Rich Plasma PRPCommercial4Original policy ↗
Podiatric Q ModifiersCommercial, Medicaid—Original policy ↗
Pombiliti (cipaglucosidase alfa) MHIMedicaid · IL1Original policy ↗
Post Pay GeneralMedicaid · IL—Original policy ↗
Post-Pay Authorization AuditMedicaid · IL—Original policy ↗
Posterior Nasal Nerve AblationCommercial, Medicaid3Original policy ↗
Posterior Nasal Nerve Ablation MEDICARE3Original policy ↗
Power Enhanced, Robotically Assisted, and Microprocessor Upper and Lower Extremity OrthosesCommercial, Medicaid6Original policy ↗
Power Enhanced, Robotically Assisted, and Microprocessor Upper and Lower Extremity Orthoses: MEDICARE350b · Effective Apr 15, 20266Original policy ↗
Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities (ReWalk)244 · Commercial, Medicaid2Original policy ↗
Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities MEDICARE2Original policy ↗
Pre-Transplant and Transplant EvaluationsCommercial, Medicaid—Original policy ↗
Prescription Compound Products MHIMedicaid · IL, MS—Original policy ↗
Prescription Digital Therapeutics412 · Effective Jun 10, 2026 · Commercial, Medicaid20Original policy ↗
Prescription Digital Therapeutics412b · Medicaid20Original policy ↗
Prevymis (letermovir) MHIMedicaid · IL, MS1Original policy ↗
Prialt (ziconotide intrathecal infusion)Commercial, Medicaid1Original policy ↗
Procysbi_Cystagon (cysteamine bitartrate) MHIMedicaid · IL, MS—Original policy ↗
Prolia (denosumab) and Biosimilars MHIMedicaid · IL, MS9Original policy ↗
Prostatic Urethral Lift or UroLift for Benign Prostatic Hyperplasia BPHCommercial4Original policy ↗
Proton and Neutron Beam Radiation Therapy ServicesCommercial, Medicaid57Original policy ↗
Provenge (sipuleucel-T)Commercial, Medicaid3Original policy ↗
Psychotherapy Add On with High Level EMCommercial, Medicaid7Original policy ↗
Psychotherapy Add-On with High Level E/MPI Payment Policy 47 · Effective Oct 18, 2022 · Medicaid · IL10Original policy ↗
Psychotherapy Add-On with High Level E/M PolicyEffective Aug 21, 2025 · Medicaid7Original policy ↗
Psychotherapy Add-On with High Level E/M PolicyEffective Aug 21, 2025 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI7Original policy ↗
PT OT Initial EvaluationsCommercial, Medicaid—Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.