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Elizabeth M. Whitehorn, Director

Provider Notice Issued 01/29/2021

 

Date:   January 29,2021                                               

 To:      Long Term CareFacilities – Specialized Mental Health Rehabilitation Facilities (SMHRFs) only

 Re:      Quality of LifeEnhancement Add-on Payment for Single Occupancy Rooms - Update

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 This notice is an update to theOctober 29, 2019 Provider Notice that informed Specialized Mental HealthRehabilitation Facilities (SMHRFs) providers of the provision in Public Act 101-0010  requiring the establishment ofa per diem add-on payment for the purpose of improving the quality of life andthe quality of care for residents. 

Effective for dates of serviceon and after July 1, 2019, a $10 per day add-on is applied to all single occupancyroom claims.  The add-on rate isavailable only for rooms licensed through the Illinois Department of PublicHealth for single occupancy.  Claims forindividuals living in rooms licensed for multiple occupancy are not eligiblefor the add-on payment. 

To receive the add-on payment,SMHRF providers must bill using Revenue Code 0110.  Leave of absence (bed reserve) days are noteligible for the add-on rate. 

Healthcare and Family Serviceshas finalized the system changes necessary to pay the add-on rate forfee-for-service claims.  Claims alreadysubmitted to the Department with dates of service on and after July 1, 2019 anda revenue code of 0110 will be repriced and paid the add-on amount. 

Questionsregarding payment by Managed Care plans should be directed to the appropriateplan. 

Questions regarding this noticemay be directed to the Bureau of Long Term Care at

1-844-528-8444

 

 

KellyCunningham, Administrator

Divisionof Medical Programs