MedicaidReimbursementMedium impact
Cost Sharing for Behavioral Health Encounters
Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Feb 1, 2014
We identified it
Jun 20, 2026
Summary
Effective February 1, 2014, a $3.90 co-payment is required for behavioral health encounters for most adults covered by Medicaid. The co-payment will be automatically deducted from provider reimbursement, and providers are responsible for collecting it from patients.
Action Required
Immediately: Billing team must update patient collection procedures for behavioral health encounters to collect $3.90 co-payment from eligible adult patients. Front desk staff should identify exempt patients (nursing home residents, pregnant women, children, hospice patients, American Indians/Alaskan Natives, and other specified exemptions). Continue billing usual and customary charges without reporting the co-payment on claims - the department will automatically deduct from reimbursement.