Updates for Free Standing Dialysis Providers Related to IL Public Act 103-0593
Date: 03/25/26
This notice informs Free Standing Dialysis providers about updated billing requirements related to IL Public Act 103-0593 for delivering dialysis services to Meridian Medicaid Plan, Wellcare By Meridian, and YouthCare members who reside in a Long-Term Care (LTC) facility and receive dialysis services at that LTC facility.
Effective January 1, 2025, the Department of Health Care and Family Services (HFS) implemented a home renal dialysis add-on payment for services provided to residents of skilled nursing facilities by Free Standing Renal Dialysis providers per Public Act 103-0593.
On February 12, 2026, Meridian updated its claim system and deployed logic to react to the new HFS requirements for the condition code 74 and 80.
Claim system update and corrections: Meridian has updated its claim system to accept claims with the required logic and will allow corrected claims back to January 1, 2025, with timely filing overrides granted for providers rebilling. All corrected claims must be received by August 1, 2026, or they will not be eligible for reprocessing.
To receive the necessary add-on per day for qualified members, providers are required to bill as follows on the 837I/UB claim format:
1. Condition code 74 and 80 must be present on the claim for members residing in an LTC who received “home” dialysis
2. Member must be indicated on the HFS patient credit file, as sent to the MCOs
3. Requires bill type 072x
4. Have at least one of the following revenue codes for renal dialysis per diem coding for HFS COS 025
Revenue Code | Description |
|---|---|
0821 | Hemodialysis–outpatient or home composite or other rate |
0831 | Peritoneal Dialysis–outpatient or home composite rate |
0841 | Continuous Ambulatory Peritoneal Dialysis (CAPD)–outpatient or home, composite, or other rate |
0851 | Continuous Cycling Peritoneal Dialysis (CCPD)–composite or other rate |
For questions please contact Provider Services at 866-606-3700 or reach out to your Provider Engagement contact.