MedicaidReimbursementMedium impact
Pricing Recalculation for 340B Purchased Renal Dialysis Injectable Drugs
Illinois Medicaid - HFS·IL · Nephrology·Provider Notice
Effective date
Jun 10, 2021
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has updated its pricing system for 340B purchased renal dialysis injectable drugs, now automatically calculating reimbursement as actual acquisition cost plus $12.00 dispensing fee (capped at provider charges). The system will also run retroactive adjustments for claims from February 2013 through June 2021.
Action Required
Immediately: Renal dialysis centers billing Illinois Medicaid fee-for-service must ensure they are using modifier 'UD' and adding the $12.00 dispensing fee to actual acquisition cost for 340B purchased renal dialysis injectable drugs. Monitor Remittance Advice for Adjustment Reason Code 3560 indicating 340B repricing adjustments. Contact hospital billing consultant at 877-782-5565 with questions.