Provider Notice Issued 08/26/2022

Date:    August 26, 2022

To:       Long Term Care Facilities – Nursing Facilities

Re:      Nursing Facilities Billing for Telehealth Originating Site Fee

_________________________________________________________________________________________________________

This notice informs nursing facilities that Healthcare and Family Services (HFS) has completed system updates to allow facilities to bill an originating site facility fee for telehealth services provided during the Public Health Emergency (PHE).

The instructions below apply to Medicaid fee-for-service (FFS) claims. Providers should contact the specific HealthChoice Illinois (HCI) managed care organization (MCO) plan for further instructions.

Instructions for Billing a Telehealth Facility Fee:

• Use the National Provider Identifier (NPI) for the facility's durable medical equipment (DME) oxygen supplier enrollment. Telehealth claims are billed as a professional service. Do not use the facility NPI that is used for normal facility billing.    

• Use Procedure Code Q3014 – Telehealth Originating Site Facility Fee. 
• Use Procedure Code modifier "CR" to bypass the SMART Act 2.7% rate reduction on the service.

 
Dates of service retroactive to March 9, 2020, may be billed. Facilities will have 180 days from the date of this notice to submit claims under Q3014. The timely filing edit has been suspended to allow these claims to be processed.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims, or the applicable HCI MCO plan.

Kelly Cunningham, Administrator
Division of Medical Programs