In a May 25, 2018, notice, the Department of Healthcare and Family Services (the “Department”) announced a proposed change in the methods and standards by which the Department will reimburse providers for psychiatric and behavioral health services.[1] The proposed changes, effective for dates of service on or after July 1, 2018, through June 30, 2019, apply to psychiatric and behavioral health services rendered by a physician, advanced practice nurse or a licensed community mental health center.

In essence, the proposed change extends enhanced payments that already were extended on three separate occasions (June 30, 2017; December 31, 2017; and June 30, 2018). Note the payments apply to mental health rehabilitative services provided in or by a community mental health center as well as to the physician benefit categories. The extension will increase expenditures by approximately $13,750,000 based on current utilization patterns. Of that amount, $12,825,000 applies to the mental health rehabilitative services benefit category and $675,000 applies to the physician benefit category.

The proposed change to Illinois’ Medicaid program is subject to approval by CMS and may be modified or revised during the approval process.