The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Illinois behavioral health schedule has 32 codes.
- Every code on all 51 published schedules
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Published codes
32
Behavioral Health procedures on the 2026 schedule
Median % of Medicare
52.5%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common behavioral health procedures and what Illinois Medicaid pays
A curated sample of recognizable procedures from the 32-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.
| Code | Procedure | Illinois rate | % of Medicare |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services | $91.58 | 52.8% |
| 90792 | Psychiatric diagnostic evaluation with medical services | $93.33 | 46.2% |
| 90832 | Psychotherapy, 30 minutes | $35.24 | 41.1% |
| 90833 | Psychotherapy, 30 minutes, added to an E&M visit | $42.87 | 52.6% |
| 90834 | Psychotherapy, 45 minutes | $46.52 | 40.8% |
| 90836 | Psychotherapy, 45 minutes, added to an E&M visit | $54.17 | 52.5% |
| 90837 | Psychotherapy, 60 minutes | $68.69 | 41.1% |
| 90838 | Psychotherapy, 60 minutes, added to an E&M visit | $71.79 | 52.6% |
| 90839 | Psychotherapy for crisis, first 60 minutes | $86.20 | 53.8% |
| 90847 | Family psychotherapy with the patient, 50 minutes | $67.92 | 62% |
| 90849 | Multiple-family group psychotherapy | $59.55 | 147.4% |
| 90853 | Group psychotherapy | $32.79 | 107.9% |
| 90867 | Transcranial magnetic stimulation (TMS), initial treatment | $259.48 | -- |
| 90868 | Transcranial magnetic stimulation (TMS), subsequent treatment | $150.84 | -- |
| 90870 | Electroconvulsive therapy (ECT) | $69.41 | 38.1% |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | $26.62 | -- |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * show the schedule's representative published variant.
More Illinois Medicaid fee schedules
- Illinois physician fee schedule · 6,469 codes
- Illinois lab & imaging fee schedule · 2,095 codes
- Illinois dme & supplies fee schedule · 1,563 codes
- Illinois drugs fee schedule · 782 codes
- Illinois other services fee schedule · 185 codes
- Illinois vision fee schedule · 82 codes
Behavioral Health rates in neighboring states
Frequently asked questions
What does Illinois Medicaid pay for behavioral health services?
Illinois Medicaid publishes 32 behavioral health procedure rates effective 2026, paying a median 52.5% of the national Medicare amount for the same services. The schedule covers psychotherapy, psychiatric evaluations, substance-use treatment, and community mental health services. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.
How do Illinois's behavioral health rates compare with Medicare?
Across behavioral health codes with a national Medicare comparator, Illinois Medicaid pays a median 52.5% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.
Do behavioral health services need prior authorization in Illinois?
Illinois does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".
Where do these rates come from?
Directly from Illinois's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.
Get an email the next time Illinois changes these rates.