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HFS Provider Type 57 (Home Health Agency) is Not a Billable Provider Type to Managed Care Organizations (MCOs)

Date: 03/06/25

Meridian identified services that were being reimbursed to Provider Type 57 (Home Health Agency) in error. The system is being corrected. HFS Provider Type 57 (Home Health Agency) is not a billable provider type to MCOs, and claims will be denied with denial code, EXsb- DENY: SERVICES NOT BILLABLE TO MCO.

Providers are directed to The Division of Specialized Care for Children (DSCC) for assistance in filing claims to this agency. Please refer to their website for information, dscc.uic.edu/for-providers.

Additionally, the IAMHP Billing Guide, updated in November 2024, has billing guidance for Home Health Agencies. For questions, please contact Provider Services at 866-606-3700 or reach out to your Provider Relations contact.