MedicaidReimbursementHigh impact
New Inpatient and Outpatient DRG Grouper Versions and Updates to Hospital Reimbursement Components Effective January 1, 2016
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2016
We identified it
Jun 20, 2026
Summary
Illinois Medicaid updated their inpatient and outpatient payment systems effective January 1, 2016, implementing new DRG grouper versions and revised reimbursement components. All inpatient and outpatient claims with service dates on or after January 1, 2016 will be held temporarily until the new payment systems are fully tested.
Action Required
Immediately: Be aware that all inpatient claims with discharge dates and outpatient claims with service dates January 1, 2016 and forward will be placed on temporary hold by Illinois Medicaid. Monitor for updated hospital rate sheets and payment calculators from the Department. Contact Bureau of Rate Development and Analysis at 217-785-0710 with questions about payment delays.