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Elizabeth M. Whitehorn, Director

Provider Bulletin H-200-11-02

To: Participating Hospitals: Chief Executive Officers, Chief Financial Officers, and Patient Accounts Managers

Date: July 20, 2011

Re: Chapter H-200, Handbook for Hospital Services Reimbursement for APL Services Performed at Hospital-Owned Off-Site Clinics

As a result of recent amendments to 89 Ill. Admin. Code section 140.461, the department has updated policy for Ambulatory Procedures Listing (APL) reimbursement of services performed at hospital-owned off-site clinics.

 

Effective with dates of service on and after June 15, 2011, the department has removed handbook language that requires an APL procedure to be performed on or adjacent to the hospital premises in order to be reimbursable. However, if the APL procedure is not performed on the hospital premises, the hospital must conform to the requirement that the service be performed at an off-site clinic located within a 35-mile radius of the main hospital.

 

The Handbook for Hospital Services has been updated and is available on the department's Web site. Printed copies of this bulletin and replacement pages for the handbook are available upon written request. To ensure delivery, specify a physical street address when making a request for a paper copy. Submit your written request or fax to:

 

Illinois Department of Healthcare and Family Services
Provider Participation Unit
Post Office Box 19114
Springfield, Illinois 62794-9114
Fax Number (217) 557-8800
Email the Provider Participation Unit

 

Any questions regarding this bulletin should be directed to your facility's medical assistance consultant in the Bureau of Comprehensive Health Services at 1-877-782-5565.

 

Instructions for updating the Handbook for Hospital Services:

 

Definitions – All-Inclusive Rate; Hospital-based Organized Clinics
Remove pages vii/viii and ix/x and insert new pages vii/viii and ix/x
H-201.26 Psychiatric Ambulatory Services – Categories of Service 27 and 28
Remove pages HFS H-201 (7-10) and insert new pages HFS 201 (7-10)
H-250.5 Outpatient Payment Methodologies
Remove pages HFS H-250 (5-6) and insert new pages HFS 250 (5-6)
H-270 Ambulatory Services
Remove pages HFS H-270 (1-2) and insert new pages HFS 270 (1-2)
H-270.41 Type A Services
Remove pages HFS H-270 (7-8) and insert new pages HFS 270 (7-8)

 

Revised Pages (pdf)