MedicaidAdministrativeMedium impact
Hospital Inpatient and Outpatient Calculators for Claims Pricing Effective 7/1/14
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Summary
Illinois Department of Healthcare and Family Services has released draft inpatient and outpatient calculators for hospital claims pricing under the new rate reform system. Hospitals must enter their 12-digit provider ID to use these calculators which estimate base pricing for APR-DRGs and EAPGs but do not include add-on payments.
Action Required
Before July 1, 2014: Hospital billing teams must obtain their 12-digit provider ID from HFS.Hospitals@illinois.gov if not already known. Access the draft calculators on the Hospital Rate Reform Initiative webpage and enter the provider ID in cell E10 (APR-DRG Calculator) and cell E6 (EAPG Calculator). Review Calculator Instructions tab to understand how to use the Interactive Calculator for estimating claim payments. Note that calculators only provide base pricing estimates and do not include DSH, MPA, or MHVA add-on payments.