Molina Healthcare Illinois policies, page 2

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
Advanced Beneficiary Notice ABN Modifiers GA GX GY GZEffective Oct 23, 2023—Original policy ↗
After Hours and Weekend Care PolicyEffective Jul 30, 2025 · Commercial, Medicaid7Original policy ↗
After Hours and Weekend Care PolicyEffective Dec 12, 2023 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NV, NY, OH, SC, TX, WA, WI7Original policy ↗
Allergy TestingCommercial, Medicaid—Original policy ↗
Allogeneic Pancreatic Islet Cell Transplantation with Lantidra (donislecel-jujn)441 · Effective Aug 12, 2026 · Commercial12Original policy ↗
Allogeneic Processed Thymus Tissue–agdc (Rethymic)Commercial3Original policy ↗
Allogeneic Processed Thymus Tissue–agdc (Rethymic) MEDICARE472b3Original policy ↗
Ambulance ModifierCommercial, Medicaid6Original policy ↗
Ambulance ModifierMedicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NV, NY, OH, SC, TX, WA, WI6Original policy ↗
Ambulance ModifierMedicaid · IL6Original policy ↗
Ambulatory and Video EEG MonitoringCommercial, Medicaid23Original policy ↗
Ambulatory Echocardiograph MonitoringMedicaid—Original policy ↗
Amondys 45 (casimersen) MNR MHIMedicaid · IL1Original policy ↗
Amtagvi (lifileucel)Commercial4Original policy ↗
Anesthesia BundlingCommercial11Original policy ↗
Annual Wellness Visit sooner than 11 months following Initial (IPPE) PolicyEffective Jul 30, 2025 · Medicaid3Original policy ↗
Anticonvulsant Agents, IL Medicaid OnlyC21453-A · Effective Oct 1, 2021 · Medicaid · IL—Original policy ↗
Antidiabetic Agents IL Medicaid Only C21858-AC21858-A · Medicaid · IL—Original policy ↗
Antiemetics MHIMedicaid · IL, MS8Original policy ↗
Aortography and Peripheral AngiographyCommercial, Medicaid—Original policy ↗
Aphexda (motixafortide) MHIMedicaid · IL1Original policy ↗
Applied Behavioral Analysis for Autism Spectrum DisorderCommercial, Medicaid12Original policy ↗
Appropriate Level of Care Reimbursement34 · Medicaid · IL, MS, NV—Original policy ↗
Arterially Directed Embolic Therapy for Liver Tumors (example (e.g.), T A C E, T A E, D E B-TACE)120 · Effective Apr 8, 2026 · Commercial, Medicaid3Original policy ↗
ASC GroupersCommercial256Original policy ↗
Atopic Dermatitis IL Medicaid Only C21052-AC21052-A · Medicaid · IL—Original policy ↗
Aucatzyl (obecabtagene autoleucel)462 · Commercial5Original policy ↗
Austedo (deutetrabenazine), IL Medicaid OnlyC25216-A · Effective May 4, 2023 · Medicaid · IL—Original policy ↗
Authorization ReviewCommercial, Medicaid—Original policy ↗
Authorization ReviewMedicaid—Original policy ↗
Authorized Pain Management Services with a Claim Modifier MismatchEffective Apr 26, 2024 · Commercial, Medicaid46Original policy ↗
Autofluorescence Wound Imaging Device (MolecuLight and Multispectral Imager)Commercial, Medicaid2Original policy ↗
Autologous Chondrocyte Implantation Knee347 · Commercial4Original policy ↗
Autologous Pancreatic Islet Cell Transplantation440 · Effective Aug 12, 2026 · Commercial, Medicaid12Original policy ↗
Autonomic FunctionTestingCommercial—Original policy ↗
Back BracesCommercial, Medicaid90Original policy ↗
Balloon Sinus Ostial Dilation Balloon Sinuplasty408 · Commercial, Medicaid5Original policy ↗
Benzodiazepines IL Medicaid Only C24664-AC24664-A · Medicaid · IL—Original policy ↗
Bimzelx (bimekizumab) MHIMedicaid · IL—Original policy ↗
Blepharoplasty, Blepharoptosis Repair, and Brow Ptosis RepairCommercial, Medicaid12Original policy ↗
Bone Graft Substitutes for Bone FusionCommercial, Medicaid2Original policy ↗
Brain PETCommercial, Medicaid4Original policy ↗
Breast Cancer Genetic Testing (Tier 1 vs Tier 2)35 · Medicaid · IL20Original policy ↗
Breast Cancer Genetic Testing Tier 1 vs Tier 2Commercial, Medicaid4Original policy ↗
Breast Implant RemovalCommercial, Medicaid3Original policy ↗
Breyanzi (lisocabtagene maraleucel; liso-cel)Commercial, Medicaid9Original policy ↗
Briumvi (ublituximab) MHIMedicaid · IL, MS1Original policy ↗
Cablivi (caplacizumab) MHIMedicaid · IL, MS1Original policy ↗
Carisoprodol MHIMedicaid · IL, MS—Original policy ↗
Carvykti (ciltacabtagene autoleucel)Commercial, Medicaid9Original 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.