Molina Healthcare Illinois policies, page 5

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
Esbriet (pirfenidone) MHIMedicaid · IL, MS—Original policy ↗
ESRD 90999 No Modifier Weekly and Monthly LimitsCommercial, Medicaid1Original policy ↗
ESRD Billing for J0406 or J0606 with Modifier AXCommercial, Medicaid3Original policy ↗
Evaluation of New TechnologyCommercial, Medicaid—Original policy ↗
Evenity (romosozumab-aqqg)C17324-A · Effective Sep 6, 2026 · Medicaid · IL, MS1Original policy ↗
Evkeeza (evinacumab-dgnb) MHIMedicaid · IL, MS1Original policy ↗
Evrysdi (risdiplam) MHIMedicaid · IL, MS—Original policy ↗
Excludes 1 Note—Original policy ↗
Excludes 1 NoteMedicaid · ID, IL, MI, NV—Original policy ↗
Excludes1 NoteMedicaid · IL—Original policy ↗
Exondys 51 (eteplirsen) MNR MHIMedicaid · IL1Original policy ↗
Experimental and Investigational ServicesCommercial, Medicaid—Original policy ↗
Fabrazyme (agalsidase beta) MHIMedicaid · IL, MS1Original policy ↗
Facility Bilateral or Anatomical Modifier UseCommercial—Original policy ↗
Facility Bilateral or Anatomical Modifier UseMedicaid · AZ, CA, FL, IA, ID, IL, MA, NE, NM, NY, OH, SC, TX, UT, WA, WI—Original policy ↗
Facility Emergency Department Evaluation and Management levelingCommercial, Medicaid3Original policy ↗
Fasenra IL Medicaid Only C22068-AC22068-A · Medicaid · IL1Original policy ↗
Fee ScheduleEffective Aug 19, 2025 · Commercial, Medicaid—Original policy ↗
Firdapse (amifampridine) MHIMedicaid · IL, MS—Original policy ↗
Foot Surgery BunionectomyCommercial, Medicaid13Original policy ↗
Foot Surgery Hallux RigidusCommercial, Medicaid7Original policy ↗
Foot Surgery Lesser Toe Deformities Hammer Mallet and Claw ToeCommercial7Original policy ↗
Forteo (teriparatide) MHIMedicaid · IL, MS—Original policy ↗
Forzinity (elamipretide) MNR MHIMedicaid · IL—Original policy ↗
Fractional CO2 Laser Treatment for Traumatic and Burn ScarsCommercial2Original policy ↗
Functional Electrical Stimulation for Spinal Cord InjuryCommercial, Medicaid2Original policy ↗
Galafold (migalastat) MHIMedicaid · IL, MS—Original policy ↗
Gamifant (Emapalumab-lzsg) MHIMedicaid · IL, MS1Original policy ↗
Gastric Electrical Stimulation414 · Commercial14Original policy ↗
Gastroesophageal Reflux Disease GERD Treatment337 · Commercial12Original policy ↗
Gattex (teduglutide [rDNA origin]) MHIMedicaid · IL, MS—Original policy ↗
Gender Dysphoria Hormone Therapy - IL Medicaid OnlyC23809-A · Effective Oct 1, 2022 · Medicaid · IL4Original policy ↗
General Billing and Coding PolicyCommercial, Medicaid—Original policy ↗
General Billing and Coding PolicyMedicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NV, NY, OH, SC, TX, WA, WI—Original policy ↗
Genetic TestingCommercial, Medicaid697Original policy ↗
Genicular Artery Embolization of the Knee for Osteoarthritis410 · Commercial, Medicaid1Original policy ↗
Genicular Radiofrequency Ablation RFA and Genicular Nerve Blocks for Chronic Knee PainCommercial5Original policy ↗
Global Surgical Packages for Professional ProvidersEffective Aug 8, 2025 · Commercial, Medicaid—Original policy ↗
Global Surgical Packages for Professional ProvidersEffective Sep 1, 2023 · Medicaid · AZ, CA, FL, ID, IL, MI, NE, NM, NY, OH, TX, UT, WI—Original policy ↗
Gocovri/Osmolex (amantadine ER caps/tabs) MHIMedicaid · IL, MS—Original policy ↗
Growth Hormone (hGH, somatropin) Therapy - IL Medicaid OnlyC22969-A · Effective Apr 27, 2022 · Medicaid · IL—Original policy ↗
Heart Transplantation and Heart Transplantation with a Total Artificial HeartCommercial11Original policy ↗
Hemangeol IL Medicaid Only C21109-AC21109-A · Medicaid · IL—Original policy ↗
Hematopoietic Stem Cell Transplantation for Hematologic CancersCommercial, Medicaid26Original policy ↗
Hematopoietic Stem Cell Transplantation for Hematologic DisordersCommercial, Medicaid23Original policy ↗
Hematopoietic Stem Cell Transplantation for Non - Cancerous Diseases454 · Commercial24Original policy ↗
Hematopoietic Stem Cell Transplantation for Solid Tumors457 · Commercial, Medicaid21Original policy ↗
Hemgenix (etranacogene dezaparvovec-drlb)429 · Commercial, Medicaid3Original policy ↗
Hemophilia and Blood Factor Products MHIMedicaid · IL, MS35Original policy ↗
Hemostatic Agents MHIMedicaid · IL, MS—Original policy ↗

Back to Molina Healthcare Illinois

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.