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Elizabeth M. Whitehorn, Director

Provider Notice issued 03/04/2024

 

To:
 Community Mental Health Providers
​Date: ​March 4, 2024
​Re: Updated Community-Based Behavioral Health Fee Schedule and Billing Guidance

This notice informs providers delivering services pursuant to the Handbook for Providers of Community-Based Behavioral Services (CBS) of updates to the corresponding CBS fee schedule and provides associated billing guidance.

Updated CBS Fee Schedule

An updated CBS fee schedule has been posted effective for dates of service on and after January 1, 2024.

The Department will not adjust any fee-for-service (FFS) claims that have already been adjudicated and paid at the old rates. Providers will need to submit replacement claims if the provider's usual and customary charges would prompt the replacement claims to adjudicate at the updated higher rates.

The Department will accept electronic transactions submitted through MEDI or via 837P files to replace a payable or pending-payable FFS claim if submitted within 12 months from the original paid voucher date. To replace a single service line or entire claim, enter Claim Frequency "7." Detailed instructions on how to replace a claim electronically can be found in the Chapter 300, 837P Companion Guide.

Providers may direct requests for FFS claims to a community mental health center billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565, option sequence 1, 2, 4, then 8. Managed care questions should be directed to the applicable HealthChoice Illinois (HCI) managed care organization (MCO).

 

Kelly Cunningham, Administrator
Division of Medical Programs