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Fee Schedule and Program Changes

Fee Schedule and/or Program Changes: When Meridian receives a fee schedule update or program change from HFS, we will load the change to the claim system as quickly as possible. See below for loading schedule. At times Meridian will receive a fee schedule or program change after the effective date. Providers do not need to request reprocessing of claims as Meridian will automatically reprocess all impacted claims once the change is loaded into the claims system. Interest will apply to claims reprocessed more than 45 days after the notification of the change. Claims with billed charges less than the published charge will not be reprocessed. Providers should always bill with usual and customary charges to avoid this situation.


Production Status
In-Progress System is currently being updated to reflect change
Completed System is updated to pay claims per the HFS fee schedule or program change
No Updates Needed System is already configured to pay per HFS fee schedule or program change


 Claim Adjustment Status


Pending Claims reprocessing has not begun  
In Progress Claims to reprocess based on HFS fee schedule or program change have been identified and a project submitted  
Completed Claims reprocessing is complete  
N/A System was updated prior to receiving claims. No reprocessing needed  

Fee Schedule Updates and Program Changes

Title Date Received from HFS Effective Date Production status Completion date of Production Claims Adjustment Status and/or Completion Date
Community Care Program In-Home Service Rate Increase - Effective 4/1/2023 5/1/2023 4/1/2023 In-Progress   Pending
Rate Correction Letter for West Suburban 4/27/2023 Varies Completed 5/8/2023 In Progress
Updated LPHA (Licensed Practition 4/19/2023 4/1/2023 Completed 3/28/2023 N/A
Updated Practioner Fee Schedule - Revised Effective 1/1/2023 4/13/2023 1/1/2023 Completed 5/4/2023 In Progress
NF and SLP Rates 4/1/2023 4/6/2023 4/1/2023 Completed 4/7/2023 N/A
Updated COVID-19 fee schedule 4/6/2023 Varies Completed 4/7/2023 N/A
Coding Change for Depression Screenings Effective April 1, 2023  3/28/2023 4/1/2023 Completed 3/29/2023 N/A
Practitioner Fee Schedule eff 1/1/2023 3/15/2023 1/1/2023 Completed 3/29/2023 In-Progress
SBHC Fee Schedule eff 1/1/2023 3/15/2023 1/1/2023 Completed 4/4/2023 In-Progress
Podiatry Fee Schedule eff 1/1/2023 3/15/2023 1/1/2023 Completed 3/31/2023 In-Progress
Updated COVID-19 fee schedule 3/13/2023 1/1/2023 Completed 3/14/2023 N/A
Revised RY 23 MPA MHVA Rates (additional update on 3.10.23) 3/6/2023 10/1/2022 Completed 3/28/2023 Completed
Revised rate sheet for Montrose Behavioral Hospital for Children 2/14/2023 1/1/2023 Completed 3/28/2023 Completed
St. James final MPA rate after late appeal   2/14/2023 10/1/2022 Completed 2/24/2023 Completed
Coverage of Interprofessional Consultation Procedure Codes for Psychiatric Services Effective February 1, 2023  2/3/2023 2/1/2023 Completed 2/22/2023 N/A
Updated Practitioner Fee Schedule for 12/31/2022 1/12/2023 12/31/2022 No Updates   N/A
Medicaid Rate List for Nursing Facilities, County Nursing Facilities, and SMHRF's 1/10/2023 1/1/2023 Completed 1/12/2023 N/A
Supportive Living Program Rates Effective January 1, 2023 1/10/2023 1/1/2023 Completed 1/17/2023 N/A
Covid-19 Fee Schedule Update 1/9/2023 Varies Completed 1/12/2023 Completed
Final RY 2023 MPA and MHVA Rates to Plans - 10.03.22 - 09.30.2023 1/6/2023 10/1/2022 Completed 2/2/2023 Completed