MedicaidReimbursementHigh impact
Annual Rate Changes Effective October 1, 2017
Illinois Medicaid - HFS·IL · Palliative Care·Provider Notice
Effective date
Oct 1, 2017
We identified it
Jun 20, 2026
Summary
Illinois updated Medicaid hospice payment rates effective October 1, 2017, requiring hospice providers to use specific Value Codes (61 for home care, G8 for inpatient care) with correct CBSA geographic identifiers on claims. Providers must also verify patient enrollment status to determine whether to bill Medicaid fee-for-service or Managed Care Organizations.
Action Required
Immediately: Hospice billing team must update claims to include Value Code 61 with appropriate CBSA for routine home care (0651) and continuous home care (0652) services, and Value Code G8 with CBSA for inpatient respite care (0655) and general inpatient care (0656). Verify patient eligibility through REV System, AVRS (1-800-842-1461), or MEDI system before billing to determine if claims go to Medicaid fee-for-service or MCO. Only report one Value Code 61 and one Value Code G8 per claim to avoid rejections.