Traditional MedicareReimbursementLow impact
Updates to Hospital Medicare Inpatient Prospective Payment System (IPPS) Outlier Cost to Charge Ratios
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2015
We identified it
Jun 20, 2026
Summary
Illinois Department of Healthcare and Family Services updated Medicare Inpatient Prospective Payment System (IPPS) outlier cost-to-charge ratios for hospitals under APR-DRG payment systems. New rate sheets are posted on the department website with updated ratios for Medicare IPPS and non-Medicare IPPS hospitals.
Action Required
By January 30, 2015: Hospital billing teams should review new rate sheets on the Illinois Department website and verify accuracy of updated cost-to-charge ratios. If ratios appear incorrect, submit written appeals with supporting documentation to Illinois Department of Healthcare and Family Services Bureau of Rate Development and Analysis within 30 days of the notice date.