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Provider Notice Issued 11/24/2021

Date:   November 24, 2021

To:       Illinois Hospital Providers

Re:      Fiscal Year 2022 January through June 2022 Hospital Inpatient and Outpatient Assessment Programs - Notice of Assessments


This is to inform you that the department has determined that your facility is subject to the inpatient and outpatient assessments imposed on Illinois hospital inpatient and outpatient services under the provisions of 305 ILCS 5/5-A. 

Your facility's inpatient and outpatient assessment remittance notices for January 2022 through June 2022 of fiscal year 2022 per Public Act 101-0650, have been mailed via USPS Attn: Chief Financial Officer.  Please make your mailroom aware of these important documents. 

Also enclosed will be tax calculation worksheets detailing the bases for the inpatient and outpatient assessments. The remittance notice has the facility's name and address, the tax identification number and personal identification number (PIN) assigned by the department, the total amount due, and the due date.  

Hospitals must remit the monthly assessments using the Illinois State Treasurer's E-Pay Program. In order to use this service, your hospital will need an Internet connection, checking account information (bank routing number and account number), from which the payment will be made, and the hospital's current remittance card. If your hospital is not familiar with the Illinois State Treasurer's E-Pay Program, please contact the Bureau of Hospital and Provider Services at (217) 524-7110 or via e-mail at

In addition, each hospital is responsible for ensuring debit authorizations can be initiated from designated accounts in the appropriate dollar amount. The following are company identification numbers to be given to your banking institution, if debit block filters are used on the hospital's account. Please use 1810599849 or 9810599849 for these transactions. 

Following are instructions for remitting payment: 


Payment Category: Hospital Assessment

Payment Type: Hospital Assessments

Please enter the following information to identify the payment:

Account Number:  HFS ID # and PIN

JetPay Authorization Number:  8 digit code provided by JetPay

Click: Search

Payment amount: Enter payment amount in dollars and cents.

Click: Add Item and Checkout

Enter Billing Contact Information

Click: Next Step: Add Payment Method

Payment Method: eCheck

Enter payment information including bank routing number and account number.

Click: Next Step: Review Payment

Check Box: I agree to the Payment Terms of Service.

Click: Make Payment

Thank you for your payment notification screen may be e-mailed or printed. 

If you have any questions concerning this information, please do not hesitate to contact the Bureau of Rate Development and Analysis by e-mail at, or by telephone at 217-524-7110. 

Kathleen Staley, Chief

Bureau of Rate Development and Analysis


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