IL SB0254

Hospitals must submit separate professional claims with "place of service 21 – Inpatient Hospital" designation beginning July 1, 2021 to receive additional Long-Acting Injectable Medicaid payments for mental health or addiction treatment.

Professional claims shall list the hospital as the billing provider and the practitioner performing the procedure as the rendering provider, using appropriate Healthcare Common Procedure Coding System Level II codes and National Drug Codes.

Facilities participating in the federal 340B Drug Pricing Program must continue billing the 340B actual acquisition cost for medications.

Long-acting injectable medications for mental health or addiction are exempt from prior authorization requirements under Medicaid and managed-care plans when initiated at inpatient hospital settings or continued at outpatient treatment facilities.

Effective date: July 1, 2021.