MedicaidReimbursementMedium impact
Updates to Hospital Reimbursement Components Effective January 1, 2025
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is updating hospital reimbursement rates effective January 1, 2025, including changes to wage indexes and cost-to-charge ratios for both inpatient APR-DRG and outpatient EAPG payment systems. The grouper versions will remain unchanged, but base rates for individual hospitals will be affected.
Action Required
By January 1, 2025: Billing team should review new rate sheets posted on the Department's Hospital Reimbursement Notifications website and prepare to use updated inpatient and outpatient calculators when they become available. Monitor reimbursement amounts for Illinois Medicaid hospital claims to verify correct payment calculations under the new wage index and cost-to-charge ratios.