MedicaidReimbursementMedium impact
New EAPG added to Outpatient Expensive Drug and Device Add-on Calculation
Illinois Medicaid - HFS·IL · Oncology·Provider Notice
Effective date
Aug 1, 2023
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has added EAPG 466: Class XIV Combined Chemotherapy and Pharmacotherapy to the list of procedures that qualify for High-Cost Device Add-On payments. This change is effective retroactively to August 1, 2023, and previously paid claims will be automatically adjusted by the Department.
Action Required
Immediately: Review any claims for combined chemotherapy and pharmacotherapy services (EAPG 466) submitted since August 1, 2023, to identify potential additional reimbursement. Download the revised EAPG calculator from the Illinois Medicaid Pricing Calculators web page to verify payment calculations. Monitor for automatic claim adjustments from the Department for previously paid claims.