Illinois lawmakers have approved mental health legislation that would establish minimum reimbursement rates for behavioral health services.

The legislation tackles a longstanding problem that has left countless Illinois residents unable to find mental health providers who accept their insurance. Low reimbursement rates have driven behavioral health professionals out of insurance networks, forcing patients to either pay hundreds of dollars out-of-pocket for therapy sessions or forgo care entirely.

HB 1085 establishes reimbursement rate floors for all in-network mental health and substance use disorder services, including inpatient services, outpatient services, office visits, and residential care.

The legislation uses data from the Research Triangle Institute International’s study “Behavioral Health Parity – Pervasive Disparities in Access to In-Network Care Continue” to set minimum payment rates. The formula requires that reimbursement for each service must equal the average reimbursement percentage for Illinois medical and surgical clinicians, plus half the difference between the average and the 75th percentile, multiplied by the applicable Medicare benchmark rate.​

These requirements will apply to all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2027.

Beyond reimbursement rates, the legislation addresses several other barriers to mental health care access. Starting with policies renewed on or after January 1, 2026, insurers must:​

Cover multiple same-day services — Insurers will be required to cover all medically necessary mental health or substance use disorder services received by the same patient on the same day, whether from the same or different providers.

Include services by behavioral health trainees — Coverage will extend to services provided by graduate students and postdoctoral trainees working toward clinical licensure under supervision of fully licensed mental health professionals.

Cover 60-minute therapy sessions — Insurers must cover medically necessary 60-minute psychotherapy billed using Current Procedural Terminology Code 90837 without imposing more onerous documentation requirements than other therapy codes.

Complete credentialing within 60 days — Insurance companies must finish the contracting process with mental health providers within 60 days of receiving a completed application, and providers can bill for services at the contracted rate from the date of application submission.

The Illinois Department of Insurance will have authority to assess civil penalties of $1,000 for each violation. The department must also conduct comprehensive reviews at the end of two years, seven years, and 12 years following implementation to assess the impact on network adequacy, out-of-network utilization, and health insurance premiums.​

The legislation requires the Department of Insurance to adopt implementing rules by September 1, 2026.

The bill also amends the Counties Code, Illinois Municipal Code, and School Code to require self-insured counties, municipalities, and school districts to provide the same expanded coverage to their employees.

If signed into law by Governor Pritzker, the mental health parity provisions will take effect June 1, 2026.