Ill. Admin. Code tit. 89, § 140.459 - Payment for Therapy Services
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.
Notes
Added at 15 Ill. Reg. 6220, effective April 18, 1991
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