Provider Notice Issued 10/29/2019

Date:   October 29, 2019                                                      
 
To:      Long Term Care Facilities – Specialized Mental Health Rehabilitation Facilities (SMHRFs) only
 
Re:      Quality of Life Enhancement Add-on Payment for Single Occupancy Rooms
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This notice informs Specialized Mental Health Rehabilitation Facilities (SMHRFs) providers of the provision in Public Act 101-0010  which requires the establishment of a per diem add-on payment to Specialized Mental Health Rehabilitation Facilities (SMHRFs) for the purpose of improving the quality of life and the quality of care for residents.
 
Effective for dates of service on and after July 1, 2019, a $10 per day add-on is being applied to all single occupancy room claims.  The add-on rate is available only for rooms licensed through the Illinois Department of Public Health for single occupancy.  Claims for individuals living in rooms licensed for multiple occupancy are not eligible for 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 not eligible for the add-on rate.
 
Healthcare and Family Services is currently programming the payment system to incorporate this add-on rate.  Once completed, any claims with dates of service on and after July 1, 2019 with a revenue code of 0110 will be repriced and paid the add-on amount.  Questions regarding payment by Managed Care plans should be directed to the appropriate plan.
 
Questions regarding this notice may be directed to the Bureau of Long Term Care at
1-844-528-8444.
 
Doug Elwell
Medicaid Administrator

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