MedicaidReimbursementMedium impact
Hospital Outpatient Acute Care Rate and Outpatient Calculator Updates
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Mar 8, 2019
We identified it
Jun 20, 2026
Summary
Illinois updated hospital outpatient acute care rates effective retroactively for Critical Access Hospitals (July 1, 2018) and prospectively for Non-Critical Access Hospitals (March 8, 2019). New rate sheets and an updated outpatient calculator are available on the state website.
Action Required
Immediately: Billing teams at Illinois hospitals must download updated rate sheets from https://www.illinois.gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/dsh.aspx and use the new Outpatient Calculator Effective March 8, 2019 for pricing estimates. Critical Access Hospitals should expect retroactive adjustments for claims from July 1, 2018 through March 7, 2019. Non-Critical Access Hospitals use new rates for dates of service March 8, 2019 forward with no retroactive adjustments.