Molina Healthcare Illinois policies, page 4

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
Developmental TestingCommercial, Medicaid3Original policy ↗
Dextenza (dexamethasone intracanalicular insert) MHIMedicaid · IL1Original policy ↗
Dexycu (dexamethasone intraocular suspension) MHIMedicaid · IL1Original policy ↗
Diabetic Testing Supplies MHIMedicaid · IL, MS—Original policy ↗
Diagnosis CodeMedicaid · IL—Original policy ↗
Diagnosis Code CodingCommercial, Medicaid—Original policy ↗
Diagnosis Code CodingMedicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI—Original policy ↗
Diagnosis Code Y65 XXCommercial, Medicaid—Original policy ↗
Diclofenac topical MHIMedicaid · IL, MS—Original policy ↗
Direct Oral Anticoagulants MHIMedicaid · IL, MS—Original policy ↗
Discontinued ProceduresEffective Aug 4, 2025 · Commercial, Medicaid4Original policy ↗
Discontinued ProceduresEffective Aug 4, 2025 · Medicaid · AZ, FL, IA, ID, IL, MA, NE, NM, NY, OH, SC, TX, UT, WA, WI4Original policy ↗
Disposable Insulin Pump IL Medicaid Only C29235-AC29235-A · Medicaid · IL—Original policy ↗
DME Non Invasive Ventilator SettingsCommercial, Medicaid6Original policy ↗
DME Place of Service Separately ReimbursableCommercial, Medicaid9Original policy ↗
DME Rental Vs PurchaseCommercial629Original policy ↗
Donor Lymphocyte Infusion and Hematopoietic Stem Cell BoostsCommercial, Medicaid3Original policy ↗
Doptelet (avatrombopag) MHIMedicaid · IL, MS—Original policy ↗
DRG Clinical ValidationMedicaid · IL—Original policy ↗
Dry Eye Therapies MHIMedicaid · IL, MS—Original policy ↗
Dupixent (dupilumab), IL Medicaid OnlyC22067-A · Effective Jan 14, 2022 · Medicaid · IL—Original policy ↗
Duplicate ClaimsEffective Aug 19, 2025 · Commercial, Medicaid—Original policy ↗
Duplicate ClaimsEffective Aug 19, 2025 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NY, OH, SC, TX, WA, WI—Original policy ↗
Duplicate ClaimsMedicaid · IL—Original policy ↗
Duplication of Therapy/High Risk Combination MHIMedicaid · IL, MS—Original policy ↗
Durable Medical Equipment K F (KF)F ModifierCommercial, Medicaid14Original policy ↗
Durable Medical Equipment K F (KF)F ModifierMedicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, WI14Original policy ↗
Dynamic Exoskeletal Orthoses for Lower Extremity InjuriesCommercial, Medicaid3Original policy ↗
Egrifta SV (tesamorelin) MNRC18465-A · Effective Sep 10, 2025 · Medicaid · IL—Original policy ↗
Elaprase (idursulfase) MHIMedicaid · IL, MS1Original policy ↗
Electric Tumor Treatment Fields for Glioblastoma353 · Commercial, Medicaid3Original policy ↗
Electrocardiographic EKG or ECG Monitoring Holter or Real Time MonitoringCommercial, Medicaid—Original policy ↗
Electrostimulation and Electromagnetic Therapy for Wound Care399 · Effective Aug 12, 2026 · Commercial, Medicaid6Original policy ↗
Elevidys (delandistrogene moxeparvovec-rokl)Commercial, Medicaid3Original policy ↗
Eliquis (apixaban), IL Medicaid OnlyC18476-A · Effective Jan 1, 2020 · Medicaid · IL—Original policy ↗
Emergency Service E&M Codes and Place of Service 23Commercial5Original policy ↗
Emflaza (deflazacort) MNR MHIMedicaid · IL—Original policy ↗
Empaveli (pegcetacoplan) MHIMedicaid · IL, MS—Original policy ↗
Enbrel (etanercept) MHIMedicaid · IL, MS—Original policy ↗
Encelto (revakinagene tororetcel)Commercial2Original policy ↗
Enclosed Bed Systems329 · Commercial, Medicaid5Original policy ↗
End Stage Renal Disease (ESRD) Consolidated Billing PolicyEffective Aug 4, 2025 · Commercial, Medicaid29Original policy ↗
Endari (L-glutamine) MNR MHIMedicaid · IL—Original policy ↗
Enteral NutritionCommercial, Medicaid28Original policy ↗
Entyvio (vedolizumab) MHIMedicaid · IL, MS1Original policy ↗
Enzyme Replacement Therapy for Gaucher Disease [Cerezyme, Elelyso, Vpriv] MHIMedicaid · IL, MS3Original policy ↗
Eohilia (budesonide oral susp) MHIMedicaid · IL—Original policy ↗
EPAP for Obstructive Sleep ApneaCommercial, Medicaid2Original policy ↗
Epidural Steroid Injections For Pain ManagementCommercial, Medicaid7Original policy ↗
Erythropoiesis-stimulating agents (ESAs) MHIMedicaid · IL, MS8Original 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.