MedicaidReimbursementHigh impact
Practitioner-Administered Drug Reimbursement Rates Effective February 1, 2012
Illinois Medicaid - HFS·IL · Oncology, Hematology, Endocrinology +6 more·Provider Notice
Effective date
Feb 1, 2012
We identified it
Jun 20, 2026
Summary
Illinois Medicaid changed reimbursement rates for practitioner-administered drugs effective February 1, 2012. Providers will now be reimbursed at the lesser of their usual charge or Medicare's Average Sales Price + 6%, affecting 37 specific drug codes including chemotherapy, injections, and oral medications.
Action Required
Immediately: Billing team must update fee schedules in billing system to reflect new Illinois Medicaid reimbursement rates for all 37 listed drug codes. Verify reimbursement expectations are set to the lesser of usual charges or Medicare ASP + 6%. Monitor the Illinois Medicaid Practitioner Fee Schedule website for ongoing rate updates to additional drug codes.