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Our new Child Support Cook Central Office at 115 South LaSalle Street, Chicago, is now open for in-person assistance.  We also have other regional office locations to better serve you! 

Elizabeth M. Whitehorn, Director

Provider Notice issued 12/02/2024

 

To: All Medical Assistance Program Providers
​Date December 2, 2024
​Re:
 Confirmation of Coverage for Remote Ultrasounds per Public Act 103-0593

This notice confirms the Department of Healthcare and Family Services’ (HFS) coverage for remote ultrasound and fetal nonstress tests. This coverage is required under Public Act 103-0593 and applies to the Medicaid fee-for-service program and the managed care organizations (MCOs).

In accordance with the Act, for dates of service beginning January 1, 2025, the Department will reimburse for remote ultrasound procedures and remote fetal nonstress tests when the patient is in a residence or other off-site location from the patient's provider and the same standard of care is met as would be present during an in-person visit.

The Act states that remote ultrasounds and remote fetal nonstress tests are only eligible for reimbursement when the provider uses digital technology: (1) to collect medical and other forms of health data from a patient and to electronically transmit that information securely to a health care provider in a different location for interpretation and recommendation; (2) that is compliant with the federal Health Insurance Portability and Accountability Act of 1996; and (3) that is approved by the U.S. Food and Drug Administration.

A fetal nonstress test for at-home monitoring is only eligible for reimbursement with remote monitoring solutions that are cleared by the U.S. Food and Drug Administration for on-label use for monitoring fetal heart rate, maternal heart rate, and uterine activity.

HFS already covers the practitioner’s service related to this procedure. Place of Service code “12” will be opened for this procedure in the HFS database to designate the patient’s home as a valid Place of Service.

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

 

 

Kelly Cunningham, Administrator
Division of Medical Programs