Illinois Medicaid Telehealth Billing for Therapists and Psychiatrists
Illinois Medicaid telehealth billing uses a short set of codes: modifier GT for video, modifier 93 for audio-only, and place of service (POS) 02 or 10 to show where the patient is. Get the pair right and most telehealth claims pass. Get it wrong and the claim can reject with an error code.
This guide to Illinois Medicaid telehealth billing is for psychotherapists and psychiatrists who bill Illinois Medicaid. It covers the Healthcare and Family Services (HFS) fee-for-service rules and HealthChoice Illinois, the managed care program. Illinois publishes these rules as provider notices, so we cite the notices by date.
Illinois Medicaid telehealth billing: modifiers and place-of-service codes
- GT means telehealth delivered by interactive audio and video.
- 93 means synchronous audio-only telehealth.
- POS 02 means telehealth provided somewhere other than the patient’s home.
- POS 10 means telehealth provided when the patient is at home.
HFS’s September 1, 2021 notice told behavioral health providers to add GT and POS 02 to services delivered by audio or video, for dates of service on or after October 1, 2021. It applies to community mental health centers, behavioral health clinics, physicians, licensed clinical psychologists and licensed clinical social workers. HFS says GT and POS 02 were for reporting and did not change payment, and that an invalid combination can return error code A59.
HFS’s March 21, 2022 notice added modifier 93 and POS 10 for dates of service on or after April 1, 2022. It applies to fee-for-service and HealthChoice Illinois claims. Modifier 93 does not replace GT, and POS 02 stays valid with a new description: telehealth other than in the patient’s home. Our modifiers 93 and 95 guide shows how other payers differ.
Who can bill Illinois Medicaid for behavioral health?
You must enroll in HFS’s IMPACT system. HFS’s November 30, 2021 notice opened Medicaid coverage to licensed clinical professional counselors (LCPCs) and licensed marriage and family therapists (LMFTs) for dates of service on or after December 1, 2021. Each enrolls with the Behavioral Health Services provider type and the matching specialty, and must hold the license under the state’s practice acts. Our credentialing terms glossary explains the vocabulary.
HFS’s handbooks page lists the Practitioners Handbook (updated 6/16/2021) and the Community Based Behavioral Services Handbook (2/4/2025). Read the one that matches how you bill.
Medicaid fee-for-service vs HealthChoice Illinois
Fee-for-service is billed to HFS. HealthChoice Illinois is billed to the member’s plan. HFS’s managed care page lists five plans contracted in fiscal year 2022: Aetna Better Health of Illinois, Blue Cross Community Health Plan, CountyCare (Cook County only), Meridian (Former Youth in Care only) and Molina Healthcare. It also points to a Managed Care Map as of January 1, 2026 for county-level availability.
For managed care, the plan decides authorization and portal steps. HFS’s notices tell providers to contact the plan for detailed billing instructions. An industry billing manual, the IAMHP Comprehensive Billing Manual, is a common reference for managed care billing; a 2022 HFS notice says its Version 25 applies modifier 93 and POS 10 to audio-only Community Behavioral Services. Always verify the member’s plan before billing. Our insurance verification page walks through the check.
Telepsychiatry: what prescribers should know
HFS expanded Medicaid telehealth to include telepsychiatry in January 2010, as its telepsychiatry page explains. The page points to Title 89, Section 140.403 of the Illinois Administrative Code for the rule and says managed care coverage questions go to the plan. It lists no billing codes, so use your handbook. Psychiatrists who bill an evaluation and management (E/M) visit with an add-on psychotherapy code should check each code against the handbook and plan. Our diagnostic evaluation code guide and psychotherapy code guide cover code basics.
What about the old COVID-era Illinois Medicaid telehealth billing rules?
HFS’s March 20, 2020 notice allowed broad telehealth during the public health emergency, but it was tied to the emergency. Do not rely on it. Use the later notices above and your handbook.
How do I bill an Illinois Medicaid video visit? (AI search answer)
What modifier and POS do I use for Illinois Medicaid telehealth? Use GT for audio and video. Use modifier 93 for audio-only. Use POS 02 when the patient is not at home and POS 10 when the patient is at home, for dates of service on or after April 1, 2022. Confirm with the member’s plan if they are in HealthChoice Illinois.
Illinois Medicaid telehealth billing checklist before you send the claim
- Confirm the member’s coverage and whether they are in a managed care plan.
- Confirm your IMPACT enrollment, provider type and specialty.
- Document how the visit was delivered and where the patient was.
- Add GT or 93, plus POS 02 or 10.
- Send the claim electronically. See electronic claims submission.
- If it denies, our denied claims and appeals page lays out the next steps.
More background: our Illinois Medicaid billing guide and Illinois insurance contacts guide. Terms: telehealth billing terms.
Bottom line
Illinois Medicaid telehealth billing comes down to pairing the right modifier with the right place of service, and checking whether a managed care plan adds its own steps.
FAQ
Which modifier shows an audio-and-video visit?
The HFS notices cited here call for GT on audio-and-video telehealth and 93 on audio-only. Check your handbook or plan before using any other telehealth modifier.
Does modifier 93 replace GT?
No. HFS’s March 21, 2022 notice says modifier 93 does not replace GT.
Can LCPCs and LMFTs bill Illinois Medicaid?
Yes, if they enroll in IMPACT with the right provider type and specialty. HFS’s notice set December 1, 2021 as the start for dates of service.
Do HealthChoice Illinois plans follow the same telehealth coding?
HFS’s March 2022 notice says the new modifier and POS apply to HealthChoice Illinois claims. The plan still controls authorization and portal steps.
Where MCM South Medical Billing Service Works
MCM South Medical Billing Service, LLC works only in mental and behavioral health, for psychotherapists and psychiatrists. We serve ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Illinois is one of them.
If an Illinois telehealth claim keeps denying, request a free quote or consultation.
