MedicaidReimbursementMedium impact
Calendar Year 2026 Outpatient High Volume Hospital Determination
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
The Illinois Department of Health and Family Services has released the 2026 Outpatient High Volume Hospital determination, which designates certain hospitals as high-volume facilities for outpatient services. This status affects billing and reimbursement rates for outpatient services provided at these designated hospitals from January 1, 2026 through December 31, 2026.
Action Required
Before January 1, 2026: Billing team must access the Illinois Department's website to review the updated Outpatient High Volume Hospital determination list. Update billing system with new hospital designations to ensure correct reimbursement rates are applied for outpatient services at designated facilities. Contact Illinois Medicaid for specific rate adjustments if your practice provides services at affected hospitals.