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February 9, 2010

Reimbursement for Services Rendered at a Hospital Owned Off-Site Clinic

The Illinois Department of Healthcare and Family Services (HFS) is currently updating its Physician Handbook and have shared an advance copy of new instructions which outline how physicians can bill for laboratory and radiology services in addition to office visits provided at hospital owned off-site clinics. The reimbursement instructions are outlined in Appendix A-7 (click here). These new instructions can be applied to services already provided as long as the timely filing deadlines are met. There are no Ambulatory Listing Procedures (APLs) that are billable in hospital owned off-site clinics.

HFS has not changed its policy for Medicaid payments to hospital clinics and outpatient departments that are located on or adjacent to hospital’s campus.

Please share this memo and attachment with your Patient Accounts staff. If you have any questions, please contact Jo Ann Spoor at 217-541-1187 or at jspoor@ihastaff.org.