HB 1085 Is Now Law: What Illinois Behavioral Health Clinicians Should Know Before 2027

If you work in behavioral health, you probably know the feeling: you finish the clinical work, close the note…and then the other work begins.

Credentialing. Claims. Reimbursement rates. Documentation requests. Trying to figure out why one plan paid differently from another. Wondering whether a 60-minute session is going to trigger additional scrutiny.

None of that is why most of us got into this field. But all of it affects our ability to actually do the work.

That is why Illinois’ HB 1085, now Public Act 104-0446, deserves the attention of behavioral health providers across the state.

The legislation addresses several longstanding operational challenges affecting mental health and substance use disorder care, including reimbursement, provider contracting, billing under supervision, same-day services, and the scrutiny surrounding 60-minute psychotherapy.

While the Act itself took effect in June 2026, many of the insurance provisions will begin applying as health plans are issued, amended, delivered, or renewed beginning in 2027. For plans operating on a calendar-year basis, that generally means January 1, 2027; other plans may transition later in the year when their plan year renews. Illinois General Assembly

A new reimbursement floor

Perhaps the most discussed provision is the new reimbursement benchmark for covered in-network mental health and substance use disorder services.

For non-hospital providers, the new reimbursement floor will be 141.7% of the applicable Medicare rate. Importantly, this is a floor, not a ceiling. Providers and organizations can still negotiate reimbursement above that amount. The guidance also states that if Medicare reimbursement increases in future years, the corresponding floor increases; if Medicare reimbursement falls, the floor does not automatically move backward. 

For clinicians, this is significant because reimbursement is not simply a financial issue. Rates affect whether practices can hire, supervise, retain clinicians, maintain manageable caseloads, and continue participating in insurance networks. At the same time, clinicians should not assume that every insurance plan is affected in exactly the same way.

That makes understanding the patient’s actual plan type increasingly important.

HB 1085 goes beyond reimbursement - there are also some changes that may make day-to-day practice a little less frustrating.

The law also addresses several issues clinicians encounter in everyday practice.

One provision protects medically necessary 60-minute psychotherapy under CPT 90837. Under HB 1085, covered plans cannot single out 90837 for more frequent audits or impose more burdensome documentation requirements than they use for other psychotherapy codes. For clinicians who regularly provide 60-minute sessions, that is worth knowing. The enacted law contains those protections for applicable policies beginning with 2027 renewals. 

The Act also requires applicable insurers to complete the process for a mental health or substance use disorder provider to become a participating provider — including credential verification — within 60 days of receiving a completed application. 

Sixty days still isn't overnight.

But at least it creates a clearer expectation for a process that can otherwise feel remarkably open-ended.

Finally, HB 1085 also expands the ability of behavioral health trainees working toward licensure to provide covered services under appropriate licensed supervision, and addresses certain circumstances in which fully licensed clinicians seeking network participation may provide services under another fully licensed provider within the same group. 

This part of the law is especially important from a workforce perspective. Illinois does not only need more behavioral health professionals; it needs a viable pathway for emerging clinicians to receive supervision, gain experience, and eventually enter independent practice.

One important catch: this does not apply to every insurance plan.

Clinicians should be aware that HB 1085 does not apply to every insurance plan.

The law covers applicable plans including certain fully insured PPOs, Marketplace plans, and self-funded county, municipal, and school plans. 

There are still plenty of plans that are not covered, including many private-employer self-funded ERISA plans, HMOs, Illinois state employee plans, federal employee plans, Medicare, Medicaid, and plans that originate in another state.

So when it comes to implementation, the actual plan matters.

And because HB 1085 follows the patient’s insurance plan year, not every eligible plan will change on January 1. Most calendar-year plans will, while others may transition later in 2027 when their plan year renews.

What should practices be doing now?

Clinicians do not need to become insurance lawyers, but practices should begin preparing rather than waiting until the first 2027 claims are processed.

A useful starting point is to:

• Review your payer mix and contracts. Know which plans are actually subject to the new requirements and document your current reimbursement rates.

• Review credentialing and supervision workflows. Practices employing pre-licensed clinicians should understand how the new rules may affect billing and workforce development.

• Pay attention to CPT 90837 policies. Compare future payer documentation and audit requirements with the protections established under the Act.

• Keep records when something does not appear compliant. The Illinois Department of Insurance has stated that it will monitor implementation, and providers, facilities, and consumers may file complaints regarding insurer or third-party-administrator noncompliance. 

Why this matters to us

At According To Sykes, LLC, we believe supporting behavioral health means supporting both the people receiving care and the professionals responsible for delivering it.

HB 1085 did not become law in a vacuum, and it’s worth acknowledging something simple: advocacy works.

This legislation brought together legislators, providers, advocates, and community organizations that helped move this work forward. We’re grateful to State Representative Lindsey Lapointe and State Senator Karina Villa, as well as Thresholds, Trilogy, NASW-Illinois Chapter, NAMI Chicago , NAMI Illinois , and The People's Lobby for continuing to help Illinois’ behavioral health community understand what implementation will look like in practice. 

And more broadly, thank you to the clinicians, advocates, organizations, and legislators who spent years pushing for changes to a system that providers navigate every day.

Policy, reimbursement, supervision, and administrative systems may feel far removed from clinical work, but they shape the conditions in which clinical work is possible. Over the coming months, ATS will continue following these changes and sharing information that can help clinicians understand what they mean in practice.

Because strengthening mental healthcare requires more than asking clinicians to do more.

It also requires building systems that make it possible for them to keep doing the work.

This article is intended for informational purposes and is not legal or billing advice. Providers should review Illinois Department of Insurance guidance and their individual payer agreements when determining how HB 1085 applies to their practice.