Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 141 - SOCIAL SERVICE FOR NON-WAIVER HOME AND COMMUNITY BASED SERVICES
Subpart B - CHILDREN'S MENTAL HEALTH HOME AND COMMUNITY-BASED SERVICES
Section 141.215 - Service Reimbursement
Universal Citation: 89 IL Admin Code ยง 141.215
Current through Register Vol. 48, No. 38, September 20, 2024
a) The CMH-HCBS services detailed in Section 141.220 shall be eligible for reimbursement pursuant to the Department's published fee schedule when the services are rendered by a provider approved by the Department and are:
1) Recommended by a Licensed
Practitioner of the Healing Arts (LPHA) in consultation with the participant's
Child and Family Team (CFT), as applicable, on the participant's
IATP;
2) Provided to a participant
for the maximum reduction of mental disability and restoration to the best
possible functional level;
3)
Provided consistent with any service limitations, utilization controls, and
prior authorizations established by the Department pursuant to 89 Ill. Adm.
Code
140.40
or as detailed in this Part; and
4)
Provided for the direct benefit of the participant, which may include support
provided to immediate caregivers of the eligible participant.
b) Reimbursement for CMH-HCBS services shall not:
1) Be made for services
provided to a participant at the same time as another service that is the same
in nature and scope as the CMH-HCBS service, regardless of payer or program
source, including Federal, state, local, and private entities;
2) Include special education and related
services defined in the Individuals with Disabilities Education Improvement Act
of 2004 (20 U.S.C.
1400 et seq.) that otherwise are available to
the participant through a local education agency, or vocational rehabilitation
services that otherwise are available to the individual through a program
funded under section 110 of the federal Rehabilitation Act of 1973
(29 U.S.C.
701 et seq.); and
3) Be made to relatives, legally responsible
individuals, or legal guardians rendering services to the
participant.
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