Provider Notice issued 03/26/2020

Date:    March 26, 2020
 
To:       Transportation Providers
 
 
 
This notice informs transportation providers of a new billing requirement for reporting transportation mileage on electronic claim submissions. The electronic billing requirements apply to claims billed for participants covered under fee-for-service, HealthChoice Illinois managed care plans, and the Medicare/Medicaid Alignment Initiative (MMAI).
 
Effective with claims received on and after February 1, 2020, loaded mileage must be reported in Loop 2400, Segment CR106 on the 837P claim format. Example: CR1****A*DH*10. Miles reported should be the number of one-leg loaded miles traveled from the origin to the destination site by any type of vehicle for this service.
 
Fee-for-service claims received without the required information will be rejected with error code J74 - Missing/Invalid Loaded Miles. Managed care plan and MMAI claims will also be rejected according to the individual plan’s edits. Mileage may still be reported in Loop 2300; however, it is not a requirement. 
 
Providers who upload batch files in the Medical Electronic Data Interchange (MEDI) and providers who bill through a clearinghouse should advise their clearinghouse or software company of the necessary changes. MEDI has been programmed to include the required information in the correct format for claims that are entered via direct data entry (DDE).
 
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.
 
 
Kelly Cunningham
Interim Medicaid Administrator

Notices

 

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