When does this change take effect?

This change is effective Dec 1, 2024.

MedicaidCoverageHigh impact

Policy and Billing Changes for Physical, Occupational, and Speech Therapies

Q: Who is affected by this change?

This affects Illinois Medicaid - HFS Physical Therapy, Occupational Therapy, Speech Therapy providers in IL on Medicaid plans.

Illinois Medicaid - HFS·IL · Physical Therapy, Occupational Therapy, Speech Therapy·Provider Notice

Effective date

Dec 1, 2024

We identified it

Jun 20, 2026

Days to comply

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Summary

Starting December 1, 2024, Illinois Medicaid will increase the maximum billable units for therapy evaluations (adults) and all outpatient PT/OT/ST services from 4 to 8 units per day. Therapy services can now be billed on the same date as evaluations.

Action Required

Action needed

Before December 1, 2024: Billing team must update system settings to allow up to 8 units per day for adult therapy evaluations and all outpatient PT/OT/ST services for Illinois Medicaid patients. Update billing software to permit therapy services on same date as evaluations. Download updated Therapy Fee Schedule from Illinois HFS website.

Related policy hubs

Illinois Medicaid - HFS policies IL policy changes Physical Therapy Occupational Therapy Speech Therapy