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MedicaidReimbursementMedium impact

Reimbursement Changes Effective January 01, 2025

Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Effective January 1, 2025, Illinois Medicaid is implementing rate increases for Specialized Mental Health Rehabilitation Facilities, including updated capital rates based on 2022 property taxes and increased per diem payments for single room occupancy (minimum $35.50/day) and double room occupancy (minimum $23.25/day).

Action Required

Action needed
By January 1, 2025: Billing teams at Specialized Mental Health Rehabilitation Facilities in Illinois must update their billing systems to reflect new Medicaid per diem rates - minimum $35.50/day for single room occupancy and minimum $23.25/day for double room occupancy. Verify facility eligibility requirements for single room add-on payments (facilities must be licensed for only single occupancy and have reduced licensed capacity). Update rate calculations based on facility bed capacity tiers ($240/day for <100 beds, $230/day for 100-130 beds, $220/day for >130 beds).