Fee Schedule and Program Changes

Fee Schedule and/or Program Changes: When Meridian receives a fee schedule update or program change from HFS, we will load the change to the claim system as quickly as possible. See below for loading schedule. At times Meridian will receive a fee schedule or program change after the effective date. Providers do not need to request reprocessing of claims as Meridian will automatically reprocess all impacted claims once the change is loaded into the claims system. Interest will apply to claims reprocessed more than 45 days after the notification of the change. Claims with billed charges less than the published charge will not be reprocessed. Providers should always bill with usual and customary charges to avoid this situation.

Production Status
In-Progress	System is currently being updated to reflect change
Completed	System is updated to pay claims per the HFS fee schedule or program change
No Updates Needed	System is already configured to pay per HFS fee schedule or program change

Claim Adjustment Status
Pending	Claims reprocessing has not begun
In Progress	Claims to reprocess based on HFS fee schedule or program change have been identified and a project submitted
Completed	Claims reprocessing is complete
N/A	System was updated prior to receiving claims. No reprocessing needed

Fee Schedule Updates and Program Changes

Title	Date Received from HFS	Effective Date	Production Status	Completion Date of Production	Claims Adjustment Status and/or Completion Date
Hospice Annual Rate Changes Effective October 1, 2024	10/18/2024	10/1/2024	In-Progress		Pending
Corrections to Sub-Clinical Behavioral Health Professional Services in FQHC & RHC clinics Effective January 1, 2024	10/18/2024	1/1/2024	In-Progress		Pending
Upcoming Rate Increases DRS and Elderly Waivers	10/17/2024	1/1/2025	In-Progress		Pending
Lactation Counseling Services Fee Schedule	10/11/2024	1/1/2024	In-Progress		Pending
Doula Fee Schedule	10/11/2024	2/1/2024	In-Progress		Pending
Updated Podiatry Fee Schedule	10/10/2024	7/1/2024	In-Progress		Pending
Nursing Facility Per Diem Rate Notices - Aliya of Palos Park	10/9/2024	8/1/2023	Pending		Pending
Renal Dialysis Add-On Payment	10/8/2024	1/1/2025	In-Progress		Pending
SUPR/ DASA Rates	10/8/2024	7/1/2024	In-Progress		Pending
Updated CCBHC Rates	10/3/2024	10/1/2024	Completed	10/3/2024	N/A
Nursing Facility Per Diem Rate Notices Updated Notice 10.7.2024, 10.11.2024	10/3/2024	Varies	Pending		Pending
School Based Health Services Fee Schedule Effective 07/01/2024 Updated 09/27/2024	9/30/2024	7/1/2024	In-Progress		Pending
7/1/24 & 4.1.2024 updated Practitioner Fee Schedule Updated Fee Schedule 9.27.2024	9/20/2024	7/1/2024	Completed	10/4/2024	In Progress
Updated C19 Fee Schedule	9/20/2024	Varies	No Updates		N/A
CCBHC Provider Enrollment and Rate Information	9/17/2024	10/1/2024	Completed	9/26/2024	N/A
Upcoming Rate Increases DRS and Elderly Waivers	9/9/2024	1/1/2025	In-Progress		Pending
Capital Rate Updates and Tax Rate Changes	8/23/2024	Varies	Completed	9/9/2024	In Progress
Updated C19 fee schedule eff 4.1.24	8/2/2024	4/1/2024	Pending		Pending
Updated Therapy fee schedule eff 1.1.24	8/2/2024	1/1/2024	No Updates		N/A
New Safety Net Add-on Payments effective 7-1-2024 (updated)	7/26/2024	7/1/2024	Completed	8/6/2024	Completed
Updated Pathways to Success Rates	7/22/2024	8/1/2024	Pending		Pending
Lab Rates eff 4.1.24	7/22/2024	4/1/2024	Completed	3/28/2024	N/A
4.1.24 Pharmacist fee schedule with PRU	7/19/2024	4/1/2024	Completed	8/20/2024	N/A
7/1/24 SNF/SMHRF/SLP MCO Rates	7/19/2024	7/1/2024	Completed	7/30/2024	N/A
Updated Audiology Fee Schedule	7/19/2024	4/1/2024	Completed	8/6/2024	In Progress
SBHC fee schedule eff 4.1.24	7/19/2024	4/1/2024	Completed	8/9/2024	In Progress
Podiatric Fee Schedule eff 4.1.24	7/19/2024	4/1/2024	Completed	8/19/2024	In Progress
LPHA fee schedule with PRU	7/19/2024	4/1/2024	Completed	3/27/2024	N/A
Hospital Rate Sheet and Other Add On Rates for Montrose Behavioral Hospital - Adult Facility	7/12/2024	1/1/2024	Completed	7/15/2024	Completed
Revised 8/1/2023 Hospital Outpatient EAPG Calculator	7/8/2024	8/1/2023	No Updates		N/A
DRS Rate Increases and SCM increases approved for 8/1/24	6/24/2024	8/1/2024	Completed	7/18/2024	N/A
SUPR Rates	6/12/2024	7/1/2024	Completed	6/14/2024	N/A
New Safety Net Add-on Payments effective 7/1/2024	6/11/2024	7/1/2024	Completed	6/24/2024	N/A
Air & Ground Ambulance Rates	5/17/2024	1/1/2024	Completed	5/29/2024	Completed
LTC - Warren Barr Lieberman 4/1/2024 Rate Sheet	5/14/2024	4/1/2024	Completed	5/17/2024	N/A
Transcervical Fibroid Ablation (TFA) Coverage effective 1/1/2024	5/29/2024	1/1/2024	Completed	8/16/2024	N/A
4/1/24 SNH/SMHRF/SLP MCO Rates	4/26/2024	4/1/2024	Completed	4/24/2024	N/A
COVID-19 Fee Schedule 4/24/2024	4/24/2024	Varies	Completed	3/20/2024	In-Progress
Ventilator Enhanced Rate	4/24/2024	1/1/2024	Completed	6/16/2024	Completed
Breast Cancer Screening Rates + add-on	4/24/2024	4/1/2024	In-Progress		Pending
Lactation Support Services - Update	4/11/2024	1/1/2024	Completed	6/16/2024	N/A
$113 add-on for Outpatient Psychiatric Claims	8/24/2023	1/1/2023	In Progress		Pending

Title	Dated Received from HFS	Effective Date	Production Status	Completion Date of Production	Claims Adjustment Status and/or Completion Date
Updated IDoA Enhanced Rate Providers	3/28/2024	Varies	Completed	4/2/2024	N/A
New Practitioner Fee Schedule	3/13/2024	4/1/2024	Completed	3/28/2024	N/A
Updated CBS Fee Schedule Effective 1/1/2024	3/5/2024	1/1/2024	Completed	2/26/2024	N/A
Electric Breast Pump Change in Benefit Frequency Without Prior Approval	3/4/2024	1/1/2024	Completed	4/25/2024	Completed
Peristeen Plus A4459	2/29/2024	1/1/2024	Completed	3/29/2024	Completed
DSH MPA and MHVA Rates for 1/1/2024 - Update	2/29/2024	1/1/2024	Completed	2/29/2024	Completed
Practitioner Fee Schedule Effective 1/1/2024 Updated 2/27/2024	2/28/2024	1/1/2024	Completed	3/20/2024	Completed
Updated SBHC Fee Schedule	2/27/2024	1/1/2024	Completed	3/8/2024	N/A
Updated Audiology Fee Schedule	2/27/2024	1/1/2024	Completed	3/14/2024	Completed
Lactation Support Services - Updated Fee Schedule	2/26/2024	1/1/2024	Completed	6/16/2024	Completed
SUPR Rates Updated	2/23/2024	1/1/2024	Completed	3/1/2024	Completed
New DME Rates Effective 1/1/2024	2/21/2024	1/1/2024	Completed	3/14/2024	Completed
Implement COVID-19 Vaccine Administration Rate Change - by March 1, 2024	2/16/2024	3/1/2024	Completed	3/20/2024	Completed
HIV/AIDS Waiver - Rate Increases Effective February 9th	2/7/2024	2/9/2024	Completed	2/15/2024	Completed
New EHRS Modifier	1/30/2024	2/1/2024	Completed	2/29/2024	N/A
NF and SLP Rate Updates	1/30/2024	1/1/2024	Completed	2/8/2024	N/A
EHRS Implementation - CCUs & EHRS	1/16/2024	2/1/2024	No Updates		N/A
Final Practitioner Fee Schedule for 2023	1/10/2024	12/31/2023	Completed	3/1/2024	N/A
Updated FP (Family Planning) Fee Schedule	12/26/2023	Varies	No Updates		N/A
DSH MPA and MHVA Rates for 1/1/2024	12/19/2023	1/1/2024	Completed	2/9/2024	Completed
Updated Practitioner Fee Schedule Effective 10/1/2023	12/14/2023	10/1/2023	Completed	12/19/2023	Completed
CMHC Rates 1/1/2024	12/5/2023	1/1/2024	Completed	12/27/2023	N/A
Revised Hospital Inpatient and Outpatient Calculators Effective 1/1/2024	12/1/2023	1/1/2024	Completed	12/19/2023	N/A
Home Health Rates 1/1/2024	11/13/2023	1/1/2024	Completed	1/2/2024	N/A
Renal Dialysis Rates and Provider Updates	10/30/2023	Varies	Completed	12/1/2023	Completed
SUPR Rate Sheet FY24	10/27/2023	1/1/2024	Completed	10/11/2023	N/A
LTC Rates 10/1/2023	10/24/2023	10/1/1023	Completed	11/1/2023	N/A
NF & SLP Rates 10/1/2023	10/23/2023	10/1/2023	Completed	10/16/2023	N/A
FQHC/RHC Rates 1/1/2024	10/20/2023	1/1/2024	Completed	11/6/2023	N/A
Coverage of Acupuncture Services per Public Act 102-1037	10/18/2023	4/1/2023	Completed	1/16/2024	Completed
COVID-19 Fee Schedule Updates 9/15 & 10/22 Correction Came in 10/27/23	10/17/2023	Varies	Completed	11/1/2023	N/A
Updated Practitioner Fee Schedule, Key and Modifier Listing	10/4/2023	10/1/2023	Completed	10/26/2023	Completed
Maternity Care Billing, Transition to Global Rates	10/2/2023	10/1/2023	Completed	10/26/2023	Completed
Revised Inpatient and Outpatient Calculators Effective 10/1/2023	10/2/2023	10/1/2023	No Updates		N/A
SBHC Fee Schedule Update Ready for Posting	9/28/2023	7/1/2023	Completed	10/10/2023	N/A
Fiscal Year 2024 Safety Net Obstetrical Payment Program	9/26/2023	Varies	Completed	1/9/2024	N/A
SUPR Rate Sheet FY24 Updated 9/26/2023	9/22/2023	Varies	Completed	10/11/2023	N/A
7/1/2023 Practitioner Fee Schedule	9/13/2023	7/1/2023	Completed	9/20/2023	Completed
Reminder to MCO's for Psych add on Payment for Certain Hospitals	9/1/2023	Varies	Completed	9/14/2023	Completed
Correct Outpatient Rates for Javon Bea Hospital	8/24/2023	Varies	No Updates		N/A
Final 1/1/2023 Calculators and Rate Sheets for UHS Hospitals (IP/OP Hosp. Calculators EAPG & APR-DRG 1/1/23 - 7/31/23)	8/23/2023	1/1/2023	Completed	9/19/2023	N/A
Policy/Billing Change Effective 1/1/2024 CPT 99483	8/21/2023	1/1/2024	Completed	9/5/2023	N/A
ICF/IID and MC/DD Rate Changes Effective January 1, 2023	8/17/2023	1/1/2023	Completed	8/1/2023	N/A
Maternity Care Reimbursment Changes Effective 10/1/2023	8/15/2023	10/1/2023	No Updates		N/A
Pharmacists Billing for HIV Pre- and Post-Exposure Prophylaxis Assessment and Consultation per Public Act 102-1051	8/9/2023	1/1/2023	Completed	9/14/2023	Completed
HCBS Rate Increases Effective 1/1/2024	8/9/2023	1/1/2024	Completed	8/21/2023	N/A
Revised Outpatient EAPG Hospital Calculator - Updated	8/1/2023	8/1/2023	Completed	8/16/2023	Completed
B4105 - RELiZORB Pricing Increase	7/28/2023	6/1/2023	Completed	7/31/2023	N/A
Renal Dialysis Rates and Provider Updates	7/28/2023	Varies	Completed	8/10/2023	N/A
Rate Increase for Breast Tomosynthesis Procedures Effective 1/1/2023 per Public Act 102-1018	7/18/2023	1/1/2023	Completed	7/18/2023	Completed
Revised IP and OP Calculators Effective 8/1/2023 - With Updates	7/18/2023	8/1/2023	Completed	8/16/2023	Completed
Revised IP and OP Calculators Effective 8/1/2023 - With Updates	7/12/2023	8/1/2023	Completed	8/16/2023	Completed
NF & SLP Rates - 7/1/2023	7/6/2023	7/1/2023	Completed	7/6/2023	N/A
Practitioner Fee Schedule and Updated Key - Effective 4/1/2023	6/20/2023	4/1/2023	Completed	7/19/2023	Completed
Podiatric Fee Schedule - Effective 4/1/2023	6/20/2023	4/1/2023	Completed	7/18/2023	N/A
Practitioner Fee Schedule - Effective 1/1/2023 Updated 3/15/2023	6/6/2023	1/1/2023	No Updates		N/A
Long Acting Injectables - Effective 7/1/2023	6/2/2023	7/1/2023	Completed	2/12/2024	N/A
DME Fee Schedule O&P Codes	5/26/2023	6/1/2023	Completed	6/7/2023	N/A
Community Care Program In-Home Service Rate Increase - Effective 4/1/2023	5/1/2023	4/1/2023	Completed	3/16/2023	N/A
Rate Correction Letter for West Suburban	4/27/2023	Varies	Completed	5/8/2023	Completed
Updated LPHA (Licensed Practitioners of the Healing Arts) Fee Schedule	4/19/2023	4/1/2023	Completed	3/28/2023	N/A
NF and SLP Rates 4/1/2023	4/6/2023	4/1/2023	Completed	4/7/2023	N/A
Updated COVID-19 Fee Schedule	4/6/2023	Varies	Completed	4/7/2023	N/A
Coding Change for Depression Screenings - Effective 4/1/2023	3/28/2023	4/1/2023	Completed	3/29/2023	N/A
Practitioner Fee Schedule - Effective 1/1/2023	3/15/2023	1/1/2023	Completed	3/29/2023	Completed
SBHC Fee Schedule - Effective 1/1/2023	3/15/2023	1/1/2023	Completed	4/4/2023	N/A
Podiatry Fee Schedule - Effective 1/1/2023	3/15/2023	1/1/2023	Completed	3/31/2023	N/A
Updated COVID-19 Fee Schedule	3/13/2023	1/1/2023	Completed	3/14/2023	N/A
Revised RY 23 MPA MHVA Rates (Additional Update on 3/10/2023)	3/6/2023	10/1/2022	Completed	3/28/2023	Completed
Revised Rate Sheet for Montrose Behavioral Hospital for Children	2/14/2023	1/1/2023	Completed	3/28/2023	Completed
St. James Final MPA Rate After Late Appeal	2/14/2023	10/1/2022	Completed	2/24/2023	Completed
Coverage of Interprofessional Consultation Procedure Codes for Psychiatric Services - Effective 2/1/2023	2/3/2023	2/1/2023	Completed	2/23/2023	N/A
Updated Practitioner Fee Schedule for 12/31/2022	1/12/2023	12/31/2022	No Updates		N/A
Medicaid Rate List for Nursing Facilities, County Nursing Facilities, and SMHRF's	1/10/2023	1/1/2023	Completed	1/12/2023	N/A
Supportive Living Program Rates - Effective 1/1/2023	1/10/2023	1/1/2023	Completed	1/17/2023	N/A
COVID-19 Fee Schedule Update	1/9/2023	Varies	Completed	1/12/2023	Completed
Final RY 2023 MPA and MHVA Rates to Plans - 10/3/2022-9/30/2023	1/6/2023	10/1/2022	Completed	2/2/2023	Completed
Community Care Program - In-Home Rate Increase - 1/1/2023	12/22/2022	1/1/2023	Completed	12/16/2022	N/A
10/1 Rates for SNF and SLF - for Decatur Manor - Sharon Health Care Woods	12/22/2022	10/1/2022	Completed	12/28/2022	Completed
Update to Outpatient Rates for OSF St. Elizabeth - Ottata	12/16/2022	10/1/2019	Completed	1/20/2023	Completed
Correct Outpatient Rates for Javon Bea Hospital	12/16/2022	7/1/2019	Completed	1/20/2023	Completed
Updated C-19 Fee Schedule - Note on End Date of Bebtelovimab	12/14/2022	Varies	Completed	12/29/2022	N/A
Rate Increases for DRS and Aging - Effective 1/1/2023 (Homemaker)	12/8/2022	1/1/2023	Completed	12/16/2022	N/A
10/1 Practitioner Fee Schedule	12/2/2022	10/1/2022	Completed	1/17/2023	Completed
SMHRF Rate Updates	12/1/2022	Varies	Completed	12/5/2022	Completed
FQHC and RHC Rates for CY 2023 State Revision 12/5/2022	11/29/2022	1/1/2023	Completed	12/22/2022	N/A
2023 Increases - Dental and Transportation	11/18/2022	1/1/2023	Completed	12/15/2022	N/A
Retroactive Rate Change for Methodist Medical Center, Peoria (Effective 1/1/2022)	11/10/2022	1/1/2022	Completed	11/25/2022	Completed
IDOA Enhanced Rate - Homemaker Providers Increase	11/10/2022	11/1/2022	Completed	11/17/2022	N/A
New Novavax Booster Effective 10/19/22 for Age 18+ (COVID-19 Fee Schedule)	11/3/2022	10/19/2022	Completed	11/14/2022	N/A
Updates Due to Capital Rate Exceptions - Grouped by Rate Quarter (Retro LTCF Rates)	11/1/2022	Varies	Completed	11/17/2022	Completed
Advanced Copy of Updated COVID-19 Fee Schedule 91314, 0144A, 91315, 0154A - Effective 10/12/2022	10/28/2022	10/12/2022	Completed	11/4/202	Completed
Updated COVID-19 Fee Schedule	10/24/2022	Varies	Completed	12/7/2022	Completed
Quantity Limit for HCPCS A4393	10/7/2022	9/1/2022	Completed	11/8/2022	N/A
Updated (CBS) Community-based Behavioral Health Services Fee Schedule - Effective 7/1/2022	10/6/2022	7/1/2022	Completed	7/13/2022	N/A
New COVID-19 Booster Vaccinations	9/30/2022	Varies	Completed	9/15/2022	N/A
Hospice Annual Rate Changes - Effective 10/1/2022	9/22/2022	10/1/2022	Completed	9/27/2022	N/A
RY 23 Initial MPA MHVA Rates	9/19/2022	Varies	Completed	11/18/2022	Completed
Revised OP Hospital Rate Sheet for Ingalls Memorial	9/19/2022	7/1/2022	Completed	12/16/2022	Completed
Updated COVID-19 Fee Schedule	9/14/2022	Varies	Completed	9/15/2022	N/A
MonkeyPox (MPV) - Advanced Notice of Testing Code/Rate	9/2/2022	7/26/2022	Completed	9/15/2022	N/A
Renal Dialysis Rates and Provider UPdates	9/2/2022	Varies	Completed	10/25/2022	Completed
Updated Practitioner Fee Schedule - Effective 7/1/2022 Updated 8/24/22	8/24/2022	7/1/2022	Completed	9/14/2022	Completed
Updated Practitioner Fee Schedule Modifier - Effective 8/11/2022	8/11/2022	7/1/2022	Completed	4/27/2022	N/A
SUPR Rate Sheet for MCO's Version - July Version	8/3/2022	1/1/2022	Completed	8/8/2022	N/A
Hospital Outpatient Claims for Sexual Assault Treatment Services per Public Act 102-0699	7/28/2022	7/1/2022	Completed	10/3/2022	N/A
Podiatry Fee Schedule	7/25/2022	4/1/2022	Completed	8/5/2022	N/A
Updated COVID-19 Fee Schedule (Novavax Vaccine/Admin Code Addition)	7/21/2022	7/13/2022	Completed	7/25/2022	N/A
Optometry Fee Schedule Update 9/1/2022	7/18/2022	9/1/2022	Completed	7/19/2022	N/A
New Rates for LTC	7/13/2022	7/1/2022	Completed	7/20/2022	N/A
Hospital Outpatient Claims with JW Modifier	7/12/2022	11/18/2021	Completed	8/8/2022	Completed
Supportive Living SLP Rate Update	7/12/2022	7/1/2022	Completed	7/14/2022	N/A
Changes in Billing Policy for Integrated Assessment and Treatment Planning (IATP), Community Support, and Crisis Stabilization Services	7/1/2022	7/5/2022	Completed	7/8/2022	N/A
SMHRF July 1 Rate Increase (Specialized Mental Health Rehabilitation Facilities)	6/30/2022	7/1/2022	Completed	8/9/2022	N/A
Updated 2021 Practitioner Fee Schedule - Effective 4/1/2022	6/30/2022	4/1/2022	Completed	8/3/2022	Completed
OP High Volume Adjustment - Revised Rates - Effective 7/1/2022	6/30/2022	7/1/2022	Completed	8/22/2022	Completed
Birth Center Rates - Effective 7/1/2022	6/29/2022	7/1/2022	Completed	7/13/2022	N/A
Immunization Administration Rate Increase to $16.71 - Effective 7/1/2022	6/23/2022	7/1/2022	Completed	6/30/2022	N/A
HB4700 CMHC Rate Increases on Specified Services - Effective 7/1/2022	6/15/2022	7/1/2022	Completed	6/23/2022	N/A
New Modifier 93 and Place of Service 10 Have Been Added to Telehealth Benefits - Effective 7/1/2022	3/31/2022	7/1/2022	Completed	6/6/2022	N/A
Modifier 93 and Place of Service Code 10 Implementation 4/1/2022	3/21/2022	7/1/2022	Completed	4/25/2022	N/A

Fee Schedule and Program Changes

Fee Schedule Updates and Program Changes

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