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Illinois Lead Screening Requirements Effective July 1: Update for Providers

Date: 07/14/26

Effective July 1, Illinois legislation requires all children in Illinois to receive mandatory blood lead testing at 12 and 24 months, regardless of geography.1 The law also requires catch-up testing for children ages 6 and under.

Updated Blood Lead Testing Requirements2
Providers must ensure:

  1. All Medicaid enrolled children receive blood lead tests at:
    • 12 months of age
    • 24 months of age
  2. Catch-up testing is conducted for children over the age of 24 months (up to age 7) for whom no record of previous blood lead testing exists
    • A risk assessment alone does NOT meet Medicaid requirements for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)3

Provider Guidance
Acceptable testing methods

  • Initial screening may use a capillary (finger-stick) or venous sample
  • Elevated capillary results > 3.5 micrograms per deciliter must be confirmed with a venous test

Follow-up and care coordination

  • Children with elevated blood lead levels require:
    • Confirmatory testing
    • Public health intervention and ongoing monitoring
  • Complete any Illinois Department of Public Health reporting requirements4
  • Assess environmental risk factors and provide caregiver education on household exposure prevention, nutrition (iron/calcium), and hygiene practices

Documentation expectations

  • Providers must document:
    • Date of test
    • Result (value and unit)
    • Specimen type (capillary vs. venous)
  • Ensure results are included in the medical record
  • Submit claim with the appropriate billing code (CPT: 83655)

Appropriate documentation of lead screening completion on or before the patient’s second birthday fulfills the HEDIS® Lead Screening in Children (LSC-E) measure.5 Learn more in the HEDIS Quality Reference Guide.

References

1. Illinois Department of Public Health. (2026, June 25). All Children Across Illinois to Receive Blood Lead Testing.
2. Illinois Department of Healthcare and Family Services. Lead Screening.
3. Medicaid.gov. Lead Screening.
4. Illinois Department of Public Health. Lead Poisoning Prevention: Education and Training.
5. National Committee for Quality Assurance. Lead Screening in Children (LSC-E).