MedicaidReimbursementMedium impact
New Inpatient APR-DRG and Outpatient EAPG Grouper Version Updates Effective August 1, 2023
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Aug 1, 2023
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is updating their inpatient APR-DRG grouper to version 40 and outpatient EAPG grouper to version 3.18, effective August 1, 2023. Additionally, EAPG 2006 has been added to the list qualifying for High-Cost Device Add-On payments.
Action Required
Before August 1, 2023: Billing team must monitor the Illinois Department of Healthcare and Family Services website for updated inpatient and outpatient rate calculators with new rates. Update billing system settings to reflect new grouper versions (APR-DRG version 40 for inpatient, EAPG version 3.18 for outpatient) and ensure EAPG 2006 qualifies for High-Cost Device Add-On payment. Contact Bureau of Rate Development at 217-785-0710 with questions.