Date: May 29, 2020
To: Enrolled Community Mental Health Centers; Behavioral Health Clinics; and Substance Use Disorder Providers
Re: Managed Care Plan Rate Increase for Behavioral Health Services
This notice informs community mental health centers (CMHCs), behavioral health clinics (BHCs), and Substance Use Disorder (SUD) providers of rate increases prompted by the COVID-19 public health emergency. The rate increases apply to claims only for participants covered under a HealthChoice Illinois managed care plan.
Maximum rates for the codes identified in the attached tables will be increased 20% for service dates March 9 through June 30, 2020. For providers who have already billed at a usual and customary rate that is above the revised Medicaid rate, the plans will reprocess claims at the higher rate automatically.
Providers that did not bill at a usual and customary rate above the revised Medicaid rate will need to submit a corrected claim at a usual and customary rate that is above the revised rate, in order to receive this rate increase.
The IAMHP Comprehensive Billing Guide contains instructions regarding corrected claim submission. Questions regarding this notice should be directed to the appropriate managed care plan.
Kelly Cunningham
Interim Medicaid Administrator
BH SUD MCO Rate Increases by Code (xls)
