Provider Notice Issued 02/21/2020

Date:    February 21, 2020
 
To:       Advanced Practice Nurses and Physicians
 
Re:      Clarification Regarding Psychiatric Add-On Payment
 
 
This notice clarifies information that was contained in the January 7, 2020 informational notice regarding add-on payments for specific psychiatric services prompted by Public Act 101-0010.
 
The earlier notice stated that effective with dates of service beginning July 1, 2019, the psychiatric services add-on payments are authorized to participating physicians board-certified in psychiatry. These add-on payments are also authorized to advanced practice nurses who meet all the following: 1)  hold a current certification in Psychiatric and Mental Health Nursing as set forth in 68 Ill. Adm. Code 1300, in accordance with the Nurse Practice Act; 2)  have a CAP (child/adolescent psychiatric residency) or GAP (general psychiatric residency) specialty on their Department’s Legacy provider file and 3)  are enrolled in IMPACT with a psychiatric subspecialty. Providers should confirm their CAP or GAP specialty using their Provider Information Sheet.
 
These add-on payments apply to claims for participants covered under both traditional fee-for-service and managed care plans. Please refer to the January 7, 2020 notice for coding, rate, and billing details.
 
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service claims, or to the applicable managed care plan.
 
 
 
Kelly Cunningham
Interim Medicaid Administrator
 

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