CPT 27130 · Arthroplasty — Hip · Illinois Medicaid (HFS)
Total Hip Arthroplasty (THA) at Illinois Medicaid (HFS).
How Illinois Medicaid (HFS) approaches CPT 27130 (Total Hip Arthroplasty (THA)) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-02
Policy number
ILMed-Surg-2026Criteria summary
High-level themes from the Illinois Medicaid (HFS) policy of record for CPT 27130. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: IL Healthcare and Family Services — Medicaid Handbook
See the full Illinois Medicaid (HFS) criteria.
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