Illinois Medicaid pays providers using official fee schedules. These schedules are set by the Illinois Department of Healthcare and Family Services (HFS).
As of August 2026, HFS has published updated 2026 rates for most provider types.
No 2027 fee schedule has been released yet for any provider category.
Quick Summary
- The practitioner fee schedule was updated July 1, 2026
- Hospital, dental, audiology, FQHC, and nursing facility rates are set through 2026
- No official 2027 fee schedule exists yet for any provider type
- Home health rates have not changed since January 2025
- ABA therapy rates are frozen at 2022 levels
- Want to know if you qualify for coverage? Try our Medicaid eligibility calculator for 2026 to check in minutes
What Is the Illinois Medicaid Fee Schedule?
A fee schedule is a list of prices. It shows what Illinois Medicaid pays providers for each service. Every provider type, like doctors, dentists, and hospitals, has its own schedule.
HFS updates these schedules during the year. Updates can change payment amounts or add new billing codes. Providers use the schedule to bill Medicaid correctly.
Illinois Medicaid Fee Schedule Rates by Provider Type (2026)
Each provider category has its own effective date and update history. Here is where things stand as of August 2026.
| Provider Type | 2026 Effective Date | Last Updated | 2027 Schedule Status |
|---|---|---|---|
| Practitioner (physicians, NPs, PAs) | July 1, 2026 | August 11, 2026 | Not yet published |
| Hospital | January 1, 2026 | March 2, 2026 | Not yet published |
| Federally Qualified Health Center (FQHC) | Calendar Year 2026 | 2026 | Not yet published |
| Dental | January 1, 2026 | January 20, 2026 | Not yet published |
| Audiology | January 1, 2026 | April 20, 2026 | Not yet published |
| Family Planning | January 1, 2026 | April 14, 2026 | Not yet published |
| Home Health | January 1, 2025 | December 29, 2025 | No 2026 or 2027 update yet |
| Adaptive Behavior Support (ABA) | Reissued May 14, 2026 | May 14, 2026 | Rates frozen since 2022 |
| Nursing Facility | July 1, 2026 | July 27, 2026 | Not yet published |
Practitioner Fee Schedule
The practitioner schedule covers doctors, nurse practitioners, and physician assistants. HFS released three 2026 versions. The most recent takes effect July 1, 2026, and was updated August 11, 2026.
Hospital Rate Sheets
Hospital rates took effect January 1, 2026. HFS published these hospital-specific rate sheets on March 2, 2026. Each hospital has its own rate sheet on the HFS portal.
ABA Therapy Rates
HFS reissued the ABA fee schedule on May 14, 2026. Rates did not change from 2022 levels. Technician code 97153 pays $13.00 per 15-minute unit, or $52.00 per hour. Analyst code 97155 pays $20.39 per 15-minute unit, or $81.56 per hour.
Home Health Fee Schedule
Home health rates are the oldest on this list. The current schedule took effect January 1, 2025, and was last updated December 29, 2025. No 2026 update has been published yet.
How to Access the Illinois Medicaid Fee Schedule Files
Getting the official rate files takes just a few steps.
- Go to the HFS Medicaid Reimbursement portal. Visit hfs.illinois.gov/medicalproviders/medicaidreimbursement.html.
- Pick your provider category. Choose practitioner, hospital, dental, audiology, FQHC, home health, or nursing facility.
- Download the file. Files come in PDF or Excel (xlsx) format.
- Check the dates. Each file lists an effective date and a last-updated date. Always use the newest version.
Illinois Medicaid Fee Schedule FY 2027: What We Know So Far
No 2027 fee schedule has been released for any provider type as of August 21, 2026. This includes practitioner, hospital, dental, audiology, home health, FQHC, and nursing facility rates.
Even without new fee schedules, other 2027 changes are coming. Illinois Medicaid expansion adults will face new work requirements starting January 1, 2027. This means 80 hours a month of work, school, or volunteering. Redeterminations will also happen every six months instead of once a year.
Some 2027 groundwork is already underway. Hospitals had to submit 2024 cost reports by July 1, 2026, for Rate Year 2027 DSH and MPA payment decisions.
A tiered Fiscal Year 2027 MCO Assessment Program also took effect July 1, 2026, though this affects managed care organizations, not provider fee schedules directly.
What This Means If You’re a Patient
Fee schedules mostly affect what providers get paid. They don’t change what you owe as a patient with Medicaid coverage. But other 2027 changes, like work requirements and more frequent redeterminations, could affect your coverage.
Noncitizen eligibility restrictions also take effect October 1, 2026. If you’re unsure whether you still qualify, check our guide to Medicaid eligibility in 2026 or compare your state’s limits in our Medicaid income limits by state in 2026 chart.
FAQ
Q: What is the Illinois Medicaid fee schedule for 2026?
A: It’s the official list of payment rates HFS uses for Medicaid providers. Rates vary by provider type. Practitioner rates took effect July 1, 2026. Hospital, dental, audiology, FQHC, and nursing facility rates took effect earlier in 2026, with most updated throughout the year.
Q: Has Illinois published a 2027 Medicaid fee schedule yet?
A: No. As of August 21, 2026, HFS has not released any fee schedule with a 2027 effective date. This applies to every provider category, including practitioner, hospital, dental, and nursing facility rates. Check back for updates as they’re released.
Q: Where can I find Illinois Medicaid reimbursement rates?
A: All official rates are on the HFS Medicaid Reimbursement portal. You’ll find PDF and Excel files organized by provider type. Each file shows its effective date and last update. Always download directly from hfs.illinois.gov for accuracy.
Q: Did Illinois Medicaid ABA rates change in 2026?
A: No. HFS reissued the ABA fee schedule on May 14, 2026, but rates stayed the same as 2022. Technician code 97153 still pays $52.00 per hour. Analyst code 97155 still pays $81.56 per hour.
Q: Is there a 2026 home health Medicaid fee schedule in Illinois?
A: Not yet. The current home health schedule took effect January 1, 2025, and was last updated December 29, 2025. As of August 2026, HFS has not published a newer version for home health services.
Q: Will Illinois Medicaid rates change in 2027?
A: It’s not yet known. No 2027 fee schedules have been published. However, other 2027 policy changes are confirmed, including new work requirements for expansion adults starting January 1, 2027, and more frequent eligibility checks.
Sources & Disclaimer
Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against official Medicaid.gov and Illinois HFS guidelines | Last Updated: August 2026
Sources:
- Illinois HFS Medicaid Reimbursement Portal — hfs.illinois.gov/medicalproviders/medicaidreimbursement.html
- Illinois HFS Practitioner Fee Schedule — hfs.illinois.gov/medicalproviders/medicaidreimbursement/practitioner.html
- Illinois HFS FAQ on Federal Medicaid Changes — hfs.illinois.gov/info/fedresctr/faqshowwillfedchimpactmedicaid.html
Disclaimer: CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official rate information, contact Illinois HFS or visit hfs.illinois.gov.
