MedicaidCoverageMedium impact
School Based/Linked Health Center Enrollment for Behavioral Health Services
Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Illinois is expanding behavioral health services coverage at School Based/Linked Health Centers (SBHCs) for Medicaid and HealthChoice Illinois plans, with enrollment backdated to October 1, 2019. Services will be reimbursed at 75% of physician rates using specific modifiers (AJ, AH, HO) for different provider types.
Action Required
Monitor for follow-up provider notice when enrollment issue is resolved in December 2021: Update billing system to include modifiers AJ (Social Work Services), AH (Psychologist Services), and HO (LMFT and LCPC Services) for behavioral health claims at School Based/Linked Health Centers. Verify reimbursement rates are set to 75% of physician rates for these services. Contact Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service claims or applicable managed care plan for guidance on time overrides.