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Elizabeth M. Whitehorn, Director

Home Health Claims

HFS System Issue:

Home Health Claims with dates of service on or after 07/01/14 will be temporarily held while programming changes are made.

Problem:

As a result of a change in statute, rates for certain home health services are increasing effective 07/01/14. The fee schedule can be viewed at:

http://www.illinois.gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/HHFeeSchedule.aspx

To avoid underpayments to providers, a hold has been placed on all Home Health Services claims to allow for programming changes. In addition, as of July 1, 2014, the SMART Act 2.7% reimbursement rate reduction no longer applies to: intermittent home health visits, and to hourly shift services provided by a CNA.

Providers Impacted:

Home Health Agencies, Home Nursing Agencies, Certified Health Departments

Procedure Codes Impacted:

G0151, G0152, G0153, G0154, and G0156

Problem Begin Date:

Claims with dates of service on or after 07/01/14

Problem Fix Date:

To be announced.

Resolution for Impacted Claims:

Claims will be released for payment once the programming changes have been completed. Please continue to access this site for updated announcements.