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MedicaidReimbursementMedium impact

Updated Community-Based Behavioral Health Fee Schedule and Billing Guidance

Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Aug 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid updated fee schedules for community-based behavioral health services effective August 1, 2024, with higher rates for procedure codes H0038, S9482, T1005, H2019, G9001, and G9002. Providers must submit replacement claims within 12 months to receive the updated higher rates for services already paid at old rates.

Action Required

Action needed
Within 12 months of original paid voucher date: Billing team must submit replacement claims (Claim Frequency '7') via MEDI or 837P files for previously paid services using codes H0038, S9482, T1005, H2019, G9001, and G9002 if usual and customary charges would result in higher reimbursement at updated rates. Contact 877-782-5565 (options 1,2,4,8) for FFS claims assistance or HFS.Pathways@illinois.gov for Care Coordination questions.

Affected Billing Codes

H0038
S9482
T1005
H2019
G9001
G9002