The Illinois Department of Human Services/Division of Substance Use Prevention and Recovery (IDHS/SUPR) is pleased to announce that Governor J.B. Pritzker's FY23 budget has increased the outpatient substance use disorder (SUD) treatment rates by 47%.
This increase will be applied to all contract and Medicaid services that are paid through DARTS submissions and Medicaid Managed Care (MCO) delivered on or after July 1, 2022. Please see page 2 for a list of the increased rates.
These rate increases reflect the commitment of Governor Pritzker, IDHS Secretary Grace Hou, and IDHS/SUPR to help improve the quality of care and strengthen the substance use disorder treatment workforce. We are working with the Department of Healthcare and Family Services (HFS) to ensure that the rates for Medicaid claims are updated and accurate for FY23 DARTS billing.
However, if necessary, SUPR will HOLD all Medicaid claims billed through DARTS for FY'23 to ensure that services are reimbursed with the correct rate.
Organizations are also advised to routinely check Mobius reports and Medicaid remittances to ensure that rates are correctly reflected based upon the date of service.
Please contact the SUPR Help Desk at DoIT.SUPRHELP@ILLINOIS.GOV with any questions regarding this process or if billing related discrepancies are noted.
We are very happy to share this good news with you and please accept our thanks for your continued dedication and commitment to providing quality substance use disorder treatment.
Increased Rates:
Service |
Minimum Unit of Service |
Code |
Rate |
Admission and Discharge Assessment |
Quarter Hour |
AAS |
$105.56- Per Hour
$26.39- Per Quarter Hour
|
Level 1 (Individual) |
Quarter Hour |
OP |
$100.36- Per Hour
$25.09- Per Quarter Hour
|
Level 1 (Group |
Quarter Hour |
OP |
$38.04- Per Hour
$9.51- Per Quarter Hour
|
Level 2 Individual |
Quarter Hour |
OR |
$100.36- Per Hour
$25.09- Per Quarter Hour
|
Level 2 Group |
Quarter Hour |
OR |
$38.04- Per Hour
$9.51- Per Quarter Hour
|
Interpreter Services |
Quarter Hour |
IN |
$97.48- Per Hour
$24.37- Per Quarter Hour
|
Early Intervention (Individual |
Quarter Hour |
EI |
$100.36- Per Hour
$25.09- Per Quarter Hour
|
Early Intervention (Group) |
Quarter Hour |
EI |
$38.04- Per Hour
$9.51- Per Quarter Hour
|
Community Intervention |
Quarter Hour |
CIH |
$97.48- Per Hour
$24.37- Per Quarter Hour
|
Toxicology |
Per Test |
TOX |
$16.49 Per Test |
Case Management |
Quarter Hour |
CM |
$77.72- Per Hour
$19.43- Per Quarter Hour
|
Psychiatric Evaluation |
Per Encounter/Per Day |
|
$131.34 Per Encounter/ Per Day |
Medication Assisted Recovery (Methadone for Opioid Use Disorder) |
Weekly |
OP |
$113.06 Weekly |