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Elizabeth M. Whitehorn, Director

Provider Notice issued 01/29/09

Increases to Reimbursement for Physician Services

To:​ Participating Physicians, Advanced Practice Nurses (APN) and Local Health Departments​
Date:​ January 29, 2009​
Re:​

Increases to Reimbursement for Physician Services​

Effective February 1, 2009

The purpose of this notice is to inform providers that Healthcare and Family Services (HFS) will be increasing its reimbursement rates for several physician services. 

Effective for dates of service on or after February 1, 2009, the following reimbursement enhancements will be implemented:

  • State Maximum rates for Inpatient Neonatal and Pediatric Critical Care services will be increased.

  • Office consultation services and several other physician services provided to participants age 0 through 20 will receive an add-on.
  • Preventive office visits provided by Maternal and Child Health providers (MCH) and Illinois Health Connect Primary Care Providers (PCP) to participants age 21 and older will receive an add-on. 

The procedure codes and rates impacted by this change are identified on the attached chart.

 

These steps are being taken in order to ensure access to physician services for HFS enrollees. HFS hopes that these first steps will encourage physicians to broaden access for HFS enrollees. HFS will continue to assess the potential for rate increases to increase access as it considers further steps to improve quality and access to care.

 

In addition, office consultation services provided to participants age 21 and older will receive an add-on beginning with dates of services on or after June 1, 2009.  HFS will provide additional details regarding this increase in a future provider notice. 

 

Information regarding the Maternal and Child Health Program and enrolling as an MCH provider may be found on the department’s Web site.  Information regarding the Primary Care Case Management Program, called Illinois Health Connect may be found on the Illinois Health Connect Web site, or call the Illinois Health Connect Provider Helpdesk at 1-877-912-1999.

 

Your participation in our programs is greatly appreciated.  Questions regarding this notice may be directed to the Bureau of Comprehensive Health Services at 1-877-782-5565.

 

Theresa A. Eagleson, Administrator

Division of Medical Programs

 

Attachment to Increases to Reimbursement for Physician Services Effective February 1, 2009, Notice (pdf))