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MedicaidReimbursementHigh impact

Reimbursement Rate Reductions Effective May 1, 2015 through June 30, 2015

Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 1, 2015
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid is reducing reimbursement rates by 16.75% for most physician and advanced practice nurse services from May 1-June 30, 2015. Specific preventive care visit codes and certain evaluation codes are exempt from this reduction.

Action Required

Action needed
Immediately: Billing team must review the revised Illinois Medicaid fee schedule on the HFS website to understand new reimbursement rates effective May 1, 2015. Continue billing usual and customary charges - the 16.75% reduction will be applied by Medicaid automatically. Verify that exempt codes (99213, 99214, and preventive visit codes 99381-99395) are not subject to reduction. Note that dispensing fees for 340B and family planning drugs are reduced by $1.00.

Affected Billing Codes

99213
99214
99381
99382
99383
99384
99385
99391
99392
99393
99394
99395