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

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 Rate Increase - 1/01/2023 **	12/22/2022	1/1/2023	Completed	12/16/2022	N/A
10/1 rates for SNF and SLF - for Decatur Manor - Sharon Health Care Woods	12/22/2022	10/1/2022	Completed	12/28/2022	Completed
Update to Outpatient Rates for OSF St. Elizabeth – Ottawa	12/16/2022	10/1/2019	Completed	1/20/2023	Completed
Correct Outpatient rates for Javon Bea Hospital	12/16/2022	7/1/2019	Completed	1/20/2023	Completed
Updated C-19 fee schedule - Note on end date of Bebtelovimab	12/14/2022	Varies	Completed	12/29/2022	N/A
Rate increases for DRS and Aging effective 1/1/2023 (homemaker)	12/8/2022	1/1/2023	Completed	12/16/2022	N/A
10/1 Practitioner Fee Schedule	12/2/2022	10/1/2022	Completed	1/17/2023	Completed
SMHRF Rate Updates	12/1/2022	Varies	Completed	12/5/2022	Completed
Updated COVID-19 fee schedule	10/24/2022	Varies	Completed	12/7/2022	Completed
Quantity Limit for HCPCS A4393	10/7/2022	9/1/2022	Completed	11/8/2022	N/A
Updated (CBS) Community-based Behavioral Health Services Fee Schedule - Effective 07/01/2022	10/6/2022	7/1/2022	Completed	7/13/2022	N/A
New COVID-19 Booster Vaccinations	9/30/2022	Varies	Completed	9/15/2022	N/A
Hospice Annual Rate Changes Effective October 1, 2022	9/22/2022	10/1/2022	Completed	9/27/2022	N/A
RY 23 Initial MPA MHVA Rates	9/19/2022	Varies	Completed	11/18/2022	Completed
Revised OP hospital rate sheet for Ingalls Memorial	9/19/2022	7/1/2022	Completed	12/16/2022	Completed
Updated COVID-19 fee schedule	9/14/2022	Varies	Completed	9/15/2022	N/A
Monkeypox (MPV) - Advanced Notice of Testing Code/Rate	9/2/2022	7/26/2022	Completed	9/15/2022	N/A
Renal Dialysis Rate and Provider Updates	9/2/2022	Varies	Completed	10/25/2022	Completed
Updated Pracitioner Fee Schedule eff 7/1/2022	8/24/2022	7/1/2022	Completed	9/14/2022	Completed
Updated Practitioner Fee Schedule Modifier Effective 08/11/2022	8/11/2022	7/1/2022	Completed	4/27/2022	Pending
SUPR Rate Sheet for MCO's Version - July Version	8/3/2022	1/1/2022	Completed	8/8/2022	N/A
Hospital Outpatient Claims for Sexual Assault Treatment Services per Public Act 102-0699	7/28/2022	7/1/2022	Completed	10/3/2022	N/A
Podiatry Fee Schedule	7/25/2022	4/1/2022	Completed	8/5/2022	N/A
Updated COVID 19 Fee Schedule(Novavax vaccine/admin code addition)	7/21/2022	7/13/2022	Completed	7/25/2022	N/A
Optometry Fee Schedule Update 9/1/2022	7/18/2022	9/1/2022	Completed	7/19/2022	N/A
New Rates for LTC	7/13/2022	7/1/2022	Completed	7/20/2022	N/A
Hospital Outpatient Claims with JW Modifier	7/12/2022	11/18/2021	Completed	8/8/2022	Completed
Supportive Living SLP Rate Update	7/12/2022	7/1/2022	Completed	7/14/2022	N/A
Changes in Billing Policy for Integrated Assessment and Treatment Planning (IATP), Community Support, and Crisis Stabilization Services	7/1/2022	7/5/2022	Completed	7/8/2022	N/A
SMHRF July 1 Rate Increase (specialized mental health rehabilitation facilities)	6/30/2022	7/1/2022	Completed	8/9/2022	N/A
Updated 2021 Practitioner Fee Schedule - eff 4/1/22	6/30/2022	4/1/2022	Completed	8/3/2022	Completed
OP High Volume Adjustment - Revised Rates eff 7/1/2022	6/30/2022	7/1/2022	Completed	8/22/2022	Completed
Birth Center Rates eff 7/1/2022	6/29/2022	7/1/2022	Completed	7/13/2022	N/A
Immunization Administration Rate Increase to $16.71 Effective 7/1/2022	6/23/2022	7/1/2022	Completed	6/30/2022	N/A
HB4700 CMHC Rate Increases on Specified Services eff 7/1/2022	6/15/2022	7/1/2022	Completed	6/23/2022	N/A
New Modifier 93 and Place of Service 10 have been added to telehealth benefits eff 7/1/2022	3/31/2022	7/1/2022	Completed	6/6/2022	N/A
Modifier 93 and Place of Service Code 10 Implementation 4/1/2022	3/21/2022	7/1/2022	Completed	4/25/2022	N/A

Fee Schedule and Program Changes

Fee Schedule Updates and Program Changes

Other Fee Schedule Updates and Program Changes