Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 140 - MEDICAL PAYMENT
Subpart D - PAYMENT FOR NON-INSTITUTIONAL SERVICES
Section 140.459 - Payment for Therapy Services
Universal Citation: 89 IL Admin Code ยง 140.459
Current through Register Vol. 48, No. 38, September 20, 2024
a) Therapy services shall be paid at an all-inclusive rate that shall be the lower of the following. The rate shall not exceed the upper limits set in federal regulations at 42 CFR 447.321 (2012) and reimbursement is based upon the applicable modifier billed by the provider.
1) The provider's usual and customary charge
for services.
2) The maximum
reimbursement rate established by the Department.
b) Maximum Reimbursement Rates. The maximum reimbursement rate:
1) Effective July 1,
2020, therapy outpatient services provided by a hospital are reimbursed as
defined in
148.140.
2) For all other therapy services (paid per
quarter hour), rates shall be as published on the Department's website in the
Therapy Fee Schedule located at
http://www2.illinois/gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/TherapyFeeSchedule.aspx .
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