MedicaidReimbursementMedium impact
Appendix 12 of Chapter 100, General Policy and Procedures Handbook
Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Mar 19, 2014
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has updated co-payment requirements for behavioral health visits at Encounter Rate Clinics (ERCs) for adult patients. The update includes new eligibility categories, specific procedure codes subject to cost sharing, and updated co-payment amounts that replace previous guidance.
Action Required
Immediately: Billing team must download and review the updated Appendix 12 from the Illinois Medicaid General Policy and Procedures Handbook Chapter 100 on the department's website. Remove old HFS Appendix 12 pages and insert new page per instructions. Update billing system with new co-payment amounts for adult behavioral health visits at ERCs. Contact Bureau of Comprehensive Health Services at 1-877-782-5565 with questions.