MedicaidReimbursementHigh impact
ICF/IID and MC/DD Rate Changes Effective January 1, 2026
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2026
We identified it
Aug 20, 2026
Summary
Illinois HFS has implemented rate increases for ICF/IID and MC/DD facilities effective January 1, 2026, including $0.80/hour wage increases for direct support personnel and updated wages for non-executive direct care staff per federal Bureau of Labor Statistics averages. The state has repriced all claims paid at lower rates and will distribute adjustment vouchers; billing teams must ensure updated per diem rates are applied to all new and adjusted claims, and pass through payment adjustments to developmental training providers within 10 days.
Action Required
REQUIREMENTS: By September 30, 2026: Billing team must verify that all ICF/IID and MC/DD facility claims processed after January 1, 2026 are using updated per diem rates from the HFS website or MEDI portal. Download current rate sheets through the MEDI portal (Login → Internet Electronic Claims → Download File(s) → Select Entity → Download to local directory). Within 10 days of receiving payment adjustment vouchers from HFS (expected late August/early September 2026): Accounts payable or billing team must pass through all rate adjustment payments to contracted developmental training and community day services providers per 89 Ill. Admin. Code 140.646(d). Verify that all repriced claims from HFS have been received and reconciled against the state's adjustment vouchers. Update internal billing documentation and rate tables to reflect the $0.80/hour wage increase for direct support personnel ($0.60 direct wage increase + $0.20 flexible allocation) and revised non-executive direct care staff wages. Contact HFS Bureau of Long Term Care (HFS.LTC@illinois.gov) if adjustment vouchers are not received by October 1, 2026, or contact DHS (DHS.DDD.DTenrollments@illinois.gov) with rate determination questions. Failure to apply updated rates and pass through adjustments will result in underpayment to providers and potential compliance violations.