Provider Notice Issued 01/29/2021

 

Date:   January 29, 2021                                               

 To:      Long Term Care Facilities – Specialized Mental Health Rehabilitation Facilities (SMHRFs) only

 Re:      Quality of Life Enhancement Add-on Payment for Single Occupancy Rooms - Update

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 This notice is an update to the October 29, 2019 Provider Notice that informed Specialized Mental Health Rehabilitation Facilities (SMHRFs) providers of the provision in Public Act 101-0010  requiring the establishment of a per diem add-on payment 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 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 has finalized the system changes necessary to pay the add-on rate for fee-for-service claims.  Claims already submitted to the Department with dates of service on and after July 1, 2019 and 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

 

 

Kelly Cunningham, Administrator

Division of Medical Programs


Notices

 

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