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 | |
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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
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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 |