Provider Notice issued 12/20/2024

This notice informs Specialized Mental Health Rehabilitation Facilities providers that effective January 1, 2025, in accordance with Public Act 103-0593, the following rate increases will take effect.

Capital Rate

The real estate tax component of the capital rate shall be updated using the 2022 long term care site property tax bill included with the facility’s 2023 cost report that has been filed with the department. The per diem rate shall be computed by dividing the allowable facility 2022 real estate tax bill costs reported in the 2023 cost report inflated to the midpoint of the rate year by the total number of patient days reported in the same cost report. Computation of the real estate tax component shall be based on capital days as defined in the Title 89 Illinois Admin. Code, section 140.570 b) 3).

Single Room Occupancy

A payment of no less than $10.00 per day, shall be added to the existing $25.50 additional per day, for a total of at least $35.50 per day, per Medicaid-occupied bed, per single room occupancy.

A separate per diem add-on shall be paid solely and exclusively to facilities licensed for only single occupancy rooms and have reduced their licensed capacity. Facilities are not eligible for these payments if the facility contains any rooms that house more than a single occupant and have failed to reduce the facilities' licensed capacity.

The payment shall be a per diem add-on payment and based upon the new licensed bed capacity as follows:

·         For facilities with less than 100 licensed beds, the add-on payment shall result in an all-inclusive rate of $240 per day.

·         For facilities with 100 licensed beds to 130 licensed beds, the add-on payment shall result in an all-inclusive rate of $230 per day.

·         For facilities with more than 130 licensed beds, the add-on payment shall result in an all-inclusive rate of $220 per day.

Double Room Occupancy

A payment of no less than $8.75 per day, shall be added to the existing $14.50 additional per day, for a total of at least $23.25, per Medicaid-occupied bed, in each double occupancy room.

The above information will be shared with the managed care organization plans for incorporation into their claims processing systems.

If you have questions, contact the Bureau of Long Term Care via email at HFS.LTC@illinois.gov or toll free at 844-528-8444.

Kelly Cunningham, Administrator
Division of Medical Programs