Molina Healthcare Illinois policies, page 6

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
Hepatitis C Antiviral Therapy IL Medicaid Only C18433-AC18433-A · Medicaid · IL—Original policy ↗
Hereditary Angioedema Agents MHIMedicaid · IL, MS7Original policy ↗
Hetlioz (tasimelteon) MHIMedicaid · IL, MS—Original policy ↗
High Dollar PharmacyCommercial—Original policy ↗
High Level Evaluation and Management with Preventive MedicineCommercial10Original policy ↗
High-Cost Outlier Targeted (HOT) Drug Exception MHIMedicaid · IL, MS—Original policy ↗
High-Level E/M with Preventive MedicinePI Payment Policy 37 · Medicaid · IL10Original policy ↗
High-Level Evaluation and Management with Preventive Medicine10Original policy ↗
HospiceEffective Feb 19, 2025 · Commercial, Medicaid—Original policy ↗
HospiceMedicaid · IL, NV—Original policy ↗
Hospice Value Code 61Effective Aug 4, 2025 · Commercial, Medicaid—Original policy ↗
Hospital Readmission ReviewCommercial, Medicaid—Original policy ↗
Hospital Routine Supplies ServicesCommercial—Original policy ↗
Hospital Routine Supplies Services ReimbursementMedicaid · IL—Original policy ↗
Humira (adalimumab) and Biosimilars – IL Medicaid OnlyC29655-A · Effective Aug 20, 2025 · Medicaid · IL—Original policy ↗
Hyaluronic Acid InjectionsMedicaid13Original policy ↗
Hydrolyzed Enteral Formula DiagnosisCommercial30Original policy ↗
Hydrolyzed Enteral Formula – DiagnosisPI Payment Policy 36 · Medicaid · IL3Original policy ↗
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (OSA)363 · Effective Apr 8, 2026 · Commercial, Medicaid9Original policy ↗
ICD-10 First Listed DiagnosisMedicaid · IL—Original policy ↗
ICD-10 First Listed Diagnosis Coding PolicyCommercial, Medicaid—Original policy ↗
ICD-10 First Listed Diagnosis Coding Policy—Original policy ↗
ICD-10 SpecificityCommercial, Medicaid2Original policy ↗
ICD-10 Specificity1Original policy ↗
ICD-10 SpecificityMedicaid · IL1Original policy ↗
Ilaris (canakinumab) MHIMedicaid · IL, MS1Original policy ↗
Ilumya (tildrakizumab) MHIMedicaid · IL, MS1Original policy ↗
Iluvien (fluocinolone acetonide intravitreal implant) MHIMedicaid · IL1Original policy ↗
Image Guided Radiation TherapyEffective Aug 4, 2025 · Commercial, Medicaid5Original policy ↗
Image Guided Radiation TherapyEffective Aug 4, 2025 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NV, NY, OH, SC, TX, WI5Original policy ↗
Image Guided Radiation TherapyMedicaid · IL5Original policy ↗
Image-Guided Bronchoscopy Evaluation of Pulmonary LesionsCommercial, Medicaid4Original policy ↗
Imcivree IL Medicaid Only C30212-AC30212-A · Medicaid · IL—Original policy ↗
Immunoglobulin (SCIg, IVIg) MHIMedicaid · IL, MS31Original policy ↗
Implantable Intrathecal Pain PumpCommercial, Medicaid21Original policy ↗
Implantable Neurostimulator for Central Sleep Apnea340 · Commercial, Medicaid13Original policy ↗
Implantable Peripheral Nerve and Nerve Field Stimulators for Chronic Pain444 · Commercial, Medicaid28Original policy ↗
Implantable Shock Absorbers for Knee OsteoarthritisCommercial2Original policy ↗
Implanted Tibial Nerve Stimulation for Urinary IncontinenceCommercial, Medicaid8Original policy ↗
Implanted Tibial Nerve Stimulation for Urinary Incontinence MEDICARE8Original policy ↗
Incarceration Diagnosis CodeCommercial, Medicaid—Original policy ↗
Increlex (mecasermin) MHIMedicaid · IL, MS—Original policy ↗
Infertility Evaluation and Treatments476 · Commercial, Medicaid162Original policy ↗
Ingrezza IL Medicaid Only C25457-AC25457-A · Medicaid · IL—Original policy ↗
Inhaled Nitric Oxide iNO for Neonatal Hypoxic Respiratory FailureCommercial, Medicaid4Original policy ↗
Injections and Nerve Blocks for Neck and Back Pain468 · Effective Apr 8, 2026 · Commercial, Medicaid25Original policy ↗
Inpatient services billed on Outpatient bill typesMedicaid1Original policy ↗
Inpefa (sotagliflozin) MHIMedicaid · IL, MS—Original policy ↗
Inrebic (fedratinib) MHIMedicaid · IL, MS—Original policy ↗
Insulin Patch IL Medicaid Only C29237-AC29237-A · Medicaid · IL—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.