MedicaidReimbursementMedium impact
Clarification Regarding Psychiatric Add-On Payment
Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
This notice clarifies eligibility requirements for psychiatric add-on payments, specifying that advanced practice nurses must have specific certifications, CAP/GAP specialty designations, and IMPACT enrollment with psychiatric subspecialty to receive these payments. The clarification applies to services provided since July 1, 2019.
Action Required
Immediately: Psychiatric providers and advanced practice nurses should verify their eligibility for add-on payments by confirming CAP or GAP specialty designation on their Provider Information Sheet. Billing team must ensure only eligible providers (board-certified psychiatrists or qualified advanced practice nurses with proper certifications, CAP/GAP specialty, and IMPACT enrollment) are receiving psychiatric add-on payments for services billed since July 1, 2019.