In late June, the Illinois Department of Healthcare and Family Services (HFS) confirmed the public notice for the 7% rate increase for 240 OPP custom L-codes for Illinois Medicaid. This rate increase was passed in 2023 and was effective as law on 1/1/2025. The rate increase is available as of 6/1/2025.

The updated rates can be accessed here: https://hfs.illinois.gov/medicalproviders/medicaidreimbursement/dme.html

Three items of note include:

  1. Claims with old rates submitted after 1/1/2025 are eligible for retroactive updated reimbursement for the 240 listed custom L-codes.
  2. Caution: Currently, this process requires the entire initial repayment of the original claim submitted after 1/1/2025, which can be an administrative nightmare.
  3. HFS may consider other options with a clear process.

ISOP extends their thanks to all those who supported this effort along the way since 2023 including their lobbyist, Bukola Bello, Dan Hasso, CPO/L (NUPOC), Sourabh Nagale, CPO/L, Lurie Hosp. and Cristina Pena, Kay Newton, and Hanger Clinic!