Upcoming Billing Changes for HCBS Waiver Service Providers
Date: 07/29/25
Meridian would like to inform our Home and Community Based Services (HCBS) Waiver Service providers about specific upcoming IAMHP Comprehensive Billing Manual changes. The information in this notice applies to HCBS provider types 92, 93 and 98, who deliver services for the Medical Assistance Program.
The Illinois Medicaid Managed Care Organizations (MCOs), in collaboration with the Illinois Association of Medicaid Health Plans (IAMHP), have developed a Comprehensive Billing Manual for Medical Assistance Program providers. This billing manual is designed to help providers who are contracted with MCOs understand the general MCO billing requirements. There will be a change in the HCBS Service Grid in the forthcoming manual release.
Removal of codes for Respite Agency Services and Skilled Intermittent Agencies
Effective August 1, 2025, the following codes will be removed from the IAMHP manual as these services are not billed to MCOs:
- Home Health Aide (CNA), T1005-SC
- Respite Agency Services LPN, T1005-TE
- Respite Agency Services RN, T1005-TD
- Skilled Intermittent Agency, T1002 - TT
If these services are billed to Meridian’s claim system, the claim will be denied as EXsb Deny – Service Not Billable to MCO*
With the removal of service code T1002-TT for Skilled Intermittent Agency, replacement service codes G0299 and G0300 should be used. This guidance will be added to the IAMHP Billing Manual.
Service code T2020 Place of Service rule change
- CMS Place of Service Code ‘99’ will no longer be accepted
- Providers should use CMS Place of Service Code “11” for this procedure code.
- Claims received with the August 1, 2025, date of service, with Place of Service 99, will be denied with EX4B Deny – Service Not Reimbursable in Location Billed**
Providers may access the IAMHP Comprehensive Billing Manual here.
* CARC 96 / RARC N448
** CARC 58