MedicaidReimbursementMedium impact
Expansion of Advanced Practice Nurses (APN) Policy
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2006
We identified it
Jun 21, 2026
Summary
Advanced Practice Nurses (CNPs and CNSs) can now enroll with Illinois Medicaid and receive 100% of physician reimbursement rates for most services, except psychiatric services which must still be rendered by physicians. APNs can also enroll as primary care providers under the Maternal and Child Health program for enhanced rates.
Action Required
Billing team must update system to reimburse APN services at 100% of physician rates for all services except psychiatric codes 90801-90899. Verify APN enrollment status with Illinois Medicaid before billing. For APNs wanting MCH primary care provider status, complete MCH Primary Care Provider Agreement and submit to Provider Participation Unit.