Illinois Medicaid reimbursement rates
43,333 current fee-for-service and managed-care rates from Illinois Medicaid, across 123 services and 18 programs, normalized by code, provider level and unit. Each links to one of 352 official source documents.
Last retrieved 2026-10-02. History back to 2002-07-01.
- Current rates
- 43,333
- Services
- 123
- Programs
- 18
- Lines with a plan rule
- 11of 21 service lines
By industry
Applied behavior analysis (ABA)Illinois rates, labor costs and changesBehavioral healthIllinois rates, labor costs and changesHome healthIllinois rates, labor costs and changesHome care & personal careIllinois rates, labor costs and changesPrivate duty nursingIllinois rates, labor costs and changesSkilled nursing facilitiesIllinois rates, labor costs and changesHospiceIllinois rates, labor costs and changesIntellectual & developmental disabilitiesIllinois rates, labor costs and changesOutpatient therapy (PT, OT, speech)Illinois rates, labor costs and changes
Illinois rates by service
The median current rate for each service, like-for-like by unit. Follow a service to compare it with every other state.
Most-compared billing codes in Illinois
Where Illinois ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Illinois | All-state median | Rank |
|---|---|---|---|---|
| 10004 | Physician and practitioner services (fee schedule) | $29.16 | $35.52 | 16 of 19 |
| 10005 | Physician and practitioner services (fee schedule) | $48.47 | $60.63 | 15 of 19 |
| 10006 | Physician and practitioner services (fee schedule) | $33.11 | $39.90 | 15 of 19 |
| 10007 | Physician and practitioner services (fee schedule) | $59.75 | $76.74 | 15 of 19 |
| 10008 | Physician and practitioner services (fee schedule) | $36.77 | $46.94 | 14 of 19 |
| 10009 | Physician and practitioner services (fee schedule) | $71.83 | $93.03 | 15 of 19 |
| 10010 | Physician and practitioner services (fee schedule) | $49.99 | $65.32 | 15 of 19 |
| 10021 | Physician and practitioner services (fee schedule) | $48.46 | $49.77 | 13 of 19 |
| 10030 | Physician and practitioner services (fee schedule) | $92.48 | $119.43 | 14 of 19 |
| 10035 | Physician and practitioner services (fee schedule) | $55.35 | $70.26 | 16 of 19 |
| 10036 | Physician and practitioner services (fee schedule) | $28.14 | $35.41 | 16 of 19 |
| 10060 | Physician and practitioner services (fee schedule) | $69.25 | $76.16 | 11 of 19 |
| 10061 | Physician and practitioner services (fee schedule) | $121.25 | $129.16 | 12 of 19 |
| 10080 | Physician and practitioner services (fee schedule) | $69.17 | $78.73 | 11 of 19 |
| 10081 | Physician and practitioner services (fee schedule) | $128.24 | $127.86 | 9 of 19 |
| 10120 | Physician and practitioner services (fee schedule) | $68.85 | $77.44 | 12 of 19 |
| 10121 | Physician and practitioner services (fee schedule) | $121.84 | $135.29 | 14 of 19 |
| 10140 | Physician and practitioner services (fee schedule) | $77.91 | $86.45 | 12 of 19 |
| 10160 | Physician and practitioner services (fee schedule) | $63.31 | $69.52 | 12 of 19 |
| 10180 | Physician and practitioner services (fee schedule) | $127.03 | $148.10 | 14 of 19 |
| 11000 | Physician and practitioner services (fee schedule) | $26.25 | $24.52 | 7 of 19 |
| 11001 | Physician and practitioner services (fee schedule) | $14.07 | $12.36 | 7 of 19 |
| 11004 | Physician and practitioner services (fee schedule) | $385.47 | $437.21 | 14 of 19 |
| 11005 | Physician and practitioner services (fee schedule) | $530.51 | $573.02 | 13 of 19 |
| 11006 | Physician and practitioner services (fee schedule) | $477.45 | $542.16 | 14 of 19 |
| 11008 | Physician and practitioner services (fee schedule) | $187.02 | $206.56 | 13 of 19 |
| 11010 | Physician and practitioner services (fee schedule) | $183.97 | $225.24 | 15 of 19 |
| 11011 | Physician and practitioner services (fee schedule) | $200.46 | $229.46 | 14 of 19 |
| 11012 | Physician and practitioner services (fee schedule) | $279.71 | $326.26 | 14 of 19 |
| 11042 | Physician and practitioner services (fee schedule) | $57.37 | $50.80 | 8 of 19 |
| 11043 | Physician and practitioner services (fee schedule) | $146.62 | $134.21 | 7 of 19 |
| 11044 | Physician and practitioner services (fee schedule) | $213.43 | $182.12 | 4 of 19 |
| 11055 | Physician and practitioner services (fee schedule) | $14.80 | $14.80 | 10 of 19 |
| 11056 | Physician and practitioner services (fee schedule) | $14.62 | $20.38 | 17 of 19 |
| 11057 | Physician and practitioner services (fee schedule) | $19.08 | $26.13 | 17 of 19 |
| 11102 | Physician and practitioner services (fee schedule) | $24.80 | $32.23 | 16 of 19 |
| 11103 | Physician and practitioner services (fee schedule) | $14.38 | $18.65 | 16 of 19 |
| 11104 | Physician and practitioner services (fee schedule) | $31.81 | $40.43 | 15 of 19 |
| 11105 | Physician and practitioner services (fee schedule) | $16.97 | $22.05 | 15 of 19 |
| 11106 | Physician and practitioner services (fee schedule) | $37.52 | $49.21 | 16 of 19 |
Managed care in Illinois
71 plans on record, 96 state-directed payment records, 40 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Illinois publish its Medicaid fee schedules?
Illinois publishes rates across 352 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Illinois publish?
43,333 rates are current across 123 services and 18 programs, with 293,585 versions on record since 2002-07-01.
Do Illinois Medicaid managed-care plans pay the fee schedule?
For 11 of 21 service lines, plan contracts or state law set a rule plans must follow (a floor, a state-set rate or a required pass-through). For the rest, plans negotiate. See the managed-care page for each line's rule and citation.
Other states
Your Illinois rate cardYour codes, what Illinois pays, what plans must pay, and every change in 2026.