Please see Provider Notice on directed payments for ACT and CST. To facilitate the payment process from the MCOs, providers must take the steps outlined – see Steps 1, 2a, and 2b.
Directed Payment reports which break down payments by provider have also been posted. Links are included below.
- PA 102-0699 CST Directed Payments Provider Breakdown (pdf)
- PA 102-0699 ACT Directed Payments Provider Breakdown (pdf)
- 06.26.23 CMH Directed Payments Provider Breakdown PA 102-1118 (pdf)
Date: July 18, 2023
To: Enrolled Community Mental Health Centers; Behavioral Health Clinics
Re: Directed Payments for Assertive Community Treatment and Community Support Team Services
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Pursuant to PA 102-0699, the Department has received federal approval to issue access payments to eligible community mental health providers who deliver Assertive Community Treatment (ACT) or Community Support Team (CST) services.
Providers of ACT services are eligible to receive an annual payment of $6,000 for each customer to whom the provider delivered 300 or more units of ACT services. Providers of CST services are eligible to receive to an annual payment of $4,200 for each customer to whom the provider delivered 200 or more units of CST services.
The Department has calculated the payments owed to eligible providers for state fiscal years 2023 and 2024 using claims data (both fee-for-service and managed care encounter claims) from service dates in calendar year 2019. The Department has posted the calculations for the combined FY23 and FY24 ACT and CST directed payments on its community mental health reimbursement webpage under the section titled “Directed Payment Reports” found at the bottom of the webpage.
Payments from Healthcare and Family Services (HFS)
For customers served who were in the fee-for-service (FFS) system, payments will be made to providers directly by HFS. The FFS payments will be issued to the pay-to provider (payee) designated on the provider’s IMPACT provider record and will be issued via State warrant (check) or via direct deposit/electronic funds transfer (EFT) by the Illinois Office of the Comptroller.
Payments from HealthChoice Illinois Managed Care Organizations (MCOs)
For customers served who were enrolled in managed care, payments will be made to providers directly by the appropriate MCO. To facilitate the payment process from the MCOs, providers must take the following steps:
- Review the Department’s posted ACT and CST payment calculation reports to determine if the provider is eligible to receive a payment.
- If eligible for payment, the provider must prepare and submit the following information to HFS via email to HFS.BBH@illinois.gov:
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- The Community Mental Health Directed Payment Form.
- A current W-9, as the MCOs will be responsible for issuing 1099 forms for these payments.
Once both documents are received, the Department will share the information with the necessary MCOs on the provider’s behalf. The MCOs will then issue the payment to the provider. Please note: MCO payments cannot be issued until Steps 1, 2a, and 2b indicated above have been completed by the provider.
Both HFS and the MCOs will be tracking when and where payments are sent and will be able to provide this information upon request.
Questions regarding this notice may be directed to HFS.BBH@illinois.gov.
Kelly Cunningham
Medicaid Administrator