MedicaidAdministrativeMedium impact
New Source of Admission and Patient Status Codes for UB-92 and Cost Outlier Payment Calculation Revision
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2006
We identified it
Jun 21, 2026
Summary
New UB-92 billing codes are now available for hospital admissions: Source of Admission code 'D' for intra-facility transfers and Patient Status code '66' for discharges to Critical Access Hospitals. Additionally, cost outlier payment calculations have been revised with new multipliers for DRG and per diem reimbursed services.
Action Required
Immediately: Hospital billing teams must update UB-92 forms and billing systems to include new Source of Admission code 'D' (Transfer from Hospital Inpatient in Same Facility) and Patient Status code '66' (Discharged to Critical Access Hospital) for applicable cases. Update DRG Payment Calculation Worksheets per Appendix H-22f with new cost outlier multipliers (1.47 for DRG services, 0.18 factor for per diem services). Download updated handbook pages from HFS website and replace outdated versions.