MedicaidReimbursementLow impact
Cost Outlier Payment Calculation – Change to Children´s Hospital Eligibility
Illinois Medicaid - HFS·IL · Pediatrics·Provider Notice
Effective date
Jul 1, 2009
We identified it
Jun 21, 2026
Summary
Children's hospitals in Illinois are now eligible to receive cost outlier payments for patients through age 18 (previously had age restrictions). The state will automatically adjust affected paid claims once programming changes are complete.
Action Required
No immediate action required. Illinois Medicaid will automatically process claim adjustments for eligible children's hospital outlier payments once their programming is complete. Monitor for automatic adjustments on previously submitted claims for pediatric patients.