MedicaidReimbursementHigh impact
New Inpatient APR-DRG and Outpatient EAPG Grouper Version Updates Effective July 1, 2019
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is updating their inpatient and outpatient payment grouper systems effective July 1, 2019. Hospitals must prepare for new APR-DRG Version 36 for inpatient claims and EAPG Version 3.13 for outpatient claims, which will affect reimbursement calculations.
Action Required
By July 1, 2019: Billing team must update systems to accommodate new APR-DRG Version 36 for inpatient discharge dates and EAPG Version 3.13 for outpatient dates of service. Download new rate calculators from the Illinois Department website and update billing software accordingly. Monitor for individual hospital rate sheets to be posted. Contact Bureau of Rate Development at 217-785-0710 with questions.