Medicare AdvantageReimbursementMedium impact
Illinois House Bill Aims to Increase In-Network Options for MH/SUD Services, Effective Jan. 1, 2027
BCBS Illinois·IL · Psychiatry·General
Effective date
Jan 1, 2027
We identified it
Sep 15, 2026
Summary
Illinois House Bill 1085 (Public Act 104-0446) simplifies network participation for mental health and substance use disorder (MH/SUD) providers effective January 1, 2027. The legislation impacts reimbursement rates, network enrollment timelines, how MH/SUD services are reimbursed, and coverage for behavioral health trainees. Billing teams should monitor for reimbursement rate changes and updated network participation requirements.
Action Required
By December 31, 2026: Billing team must coordinate with MH/SUD department and compliance to obtain and implement updated reimbursement rates for mental health and substance use disorder services. Verify which MH/SUD providers are newly in-network through Blue Cross Blue Shield Illinois. Update billing system fee schedules to reflect new reimbursement rates and ensure prior authorization workflows reflect any changes to coverage for behavioral health trainee services. Notify providers of rate changes and any updates to eligibility verification. Failure to update rates may result in incorrect claim submission and denials.