Molina Healthcare Illinois policies, page 11

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
PT OT ST Yearly LimitEffective Aug 19, 2025 · Commercial, Medicaid—Original policy ↗
Pulmicort Respules (budesonide) MHIMedicaid · IL, MS—Original policy ↗
Pulmonary Function TestingMedicaid19Original policy ↗
Qalsody (tofersen) MHIMedicaid · IL, MS1Original policy ↗
Qutenza (capsaicin) MHIMedicaid · IL, MS1Original policy ↗
Radiation Therapy ServicesCommercial, Medicaid117Original policy ↗
Radiation Therapy Services MEDICARE117Original policy ↗
Radicava (edaravone) MHIMedicaid · IL, MS1Original policy ↗
Radioembolization (Selective Internal Radiation Therapy) for Liver Tumors181 · Effective Jun 10, 2026 · Commercial, Medicaid8Original policy ↗
Radiofrequency and Pulsed Radiofrequency Ablation for Trigger Point PainCommercial, Medicaid1Original policy ↗
Radiofrequency Nerve Ablation for Neck and Back PainCommercial, Medicaid8Original policy ↗
Radiofrequency Treatment of Nasal Airway Obstruction (e.g., VivAer)Commercial, Medicaid1Original policy ↗
Radiofrequency Treatment of Nasal Airway Obstruction (e.g., VivAer) MEDICARE1Original policy ↗
Radiology Bone DensityCommercial, Medicaid2Original policy ↗
Radiology for Chest PolicyEffective Aug 20, 2025 · Commercial, Medicaid4Original policy ↗
Ranibizumab and Biosimilars (Lucentis, Byooviz, Cimerli) MHIMedicaid · IL, MS3Original policy ↗
Ravicti (glycerol phenylbutyrate) MHIMedicaid · IL, MS—Original policy ↗
ReadmissionCommercial—Original policy ↗
Readmission—Original policy ↗
Reblozyl (luspatercept-aamt) MHIMedicaid · IL, MS1Original policy ↗
Rebyota (fecal microbiota) MHIMedicaid · IL, MS1Original policy ↗
Recorlev (levoketoconazole) MHIMedicaid · IL, MS—Original policy ↗
Recovery Policy for CPT to CPT CodeCommercial, Medicaid—Original policy ↗
Recovery Policy for Diagnosis CodesCommercial—Original policy ↗
Recovery Policy for Revenue to CPT Code ReviewCommercial, Medicaid—Original policy ↗
Recovery Policy Variable Discount Payments for ProvidersCommercial, Medicaid—Original policy ↗
Reduced Services and Discontinued ProceduresCommercial, Medicaid4Original policy ↗
Reduced Services and Discontinued Procedures, Professional and Facility—Original policy ↗
Regranex (becaplermin) MHIMedicaid · IL, MS1Original policy ↗
Reimbursement Policy for Corrected ClaimsMedicaid—Original policy ↗
Reimbursement Policy for DME KF ModifierEffective Aug 1, 2023 · Medicaid · IL13Original policy ↗
Relizorb (immobilized lipase cartridge) MNR MHIMedicaid · IL1Original policy ↗
Remote Patient Monitoring419 · Effective Oct 8, 2025 · Commercial, Medicaid25Original policy ↗
Renal AutotransplantationCommercial, Medicaid1Original policy ↗
Repeat Procedure Modifiers 76 77Commercial2Original policy ↗
Repeat Procedure Modifiers 76 77Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI2Original policy ↗
Respiratory Pathogen Panel TestingEffective Sep 8, 2024 · Medicaid · IL—Original policy ↗
Respiratory Pathogen Panel Testing PolicyCommercial, Medicaid6Original policy ↗
Revcovi (elapegademase) MHIMedicaid · IL, MS1Original policy ↗
Reyvow (lasmiditan) MHIMedicaid · IL, MS—Original policy ↗
Rezurock (belumosudil) MHIMedicaid · IL, MS—Original policy ↗
Riluzole (Rilutek_Tiglutik_Exservan) MHIMedicaid · IL, MS—Original policy ↗
Rinvoq (upadacitinib)C30614-A · Effective Apr 1, 2026 · Medicaid · IL—Original policy ↗
Rituxan (rituximab) and Biosimilars MHIMedicaid · IL, MS4Original policy ↗
Robotically Assisted SurgeryCommercial, Medicaid1Original policy ↗
Ryoncil (remestemcel)Commercial3Original policy ↗
Ryplazim (plasminogen, human) MHIMedicaid · IL, MS1Original policy ↗
Rystiggo (rozanolixizumab) MHIMedicaid · IL, MS1Original policy ↗
Santyl (collagenase) MHIMedicaid · IL, MS—Original policy ↗
Saphnelo (anifrolumab) MHIMedicaid · IL, MS1Original 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.