MedicaidReimbursementMedium impact
Enhanced Rate for Court-Ordered Individuals
Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Apr 1, 2023
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is implementing a $35 per resident per day add-on rate for court-ordered individuals admitted to Specialized Mental Health Rehabilitation Facilities (SMHRF) effective April 1, 2023. Facilities must use specific revenue codes (0119 for single occupancy, 0129 for double occupancy) and meet strict requirements including room occupancy standards, no Level 4-6 findings, and quarterly reporting obligations.
Action Required
Before April 1, 2023: SMHRF billing teams must update claims processing to use Revenue Code 0119 for single occupancy rooms and Revenue Code 0129 for double occupancy rooms when billing for court-ordered individuals. Verify facility meets all requirements (single/double occupancy licensing, no Level 4-6 findings in past 12 months). Establish procedures for 90-day court progress reports and quarterly DHS liaison communications. Note that claims will be adjusted systematically once programming is complete.