Page 58 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

nurse who is licensed by Illinois or the state where
the patient is located;
• The originating and distant site provider must not
be terminated, suspended or barred from the
Department’s medical programs;
• Medical data may be exchanged through a
telecommunication system;
• The interactive telecommunication system must, at
a minimum, have the capability of allowing the
consulting distant site provider to examine the
patient sufficiently to allow proper diagnosis of the
involved body system. The system must also be
capable of transmitting clearly audible heart tones
and lung sounds, as well as clear video images of
the patient and any diagnostic tools, such as
radiographs.

An encounter clinic serving as the distant site shall be
reimbursed as follows:

1. If the originating site is another encounter clinic,
the distant site encounter clinic shall receive no
reimbursement from the Department. The
originating site encounter clinic is responsible for
reimbursement to the distant site encounter clinic;
and
2. If the originating site is not an encounter clinic, the
distant site encounter clinic shall be reimbursed for
its medical encounter. The originating site
provider will receive a facility fee.

Source: IL Admin. Code Title 89, 140.403.

Eligible originating site providers include:
• Physicians;
• Podiatrists;
• Local health departments;
• Community mental health centers;
• Outpatient hospitals;
• Encounter Rate Clinics
• Federally Qualified Health Centers (FQHC);
• Rural Health Clinics (RHC)

Eligible distant site providers include:
• Physicians;
• Podiatrists;
• Advanced practice nurses;
• Encounter Rate Clinics
• Federally Qualified Health Centers (FQHC);
• Rural Health Clinics;

Source: IL Dept. of Healthcare and Family Svcs., Expansion of
Telehealth Services, Informational Notice, Jan. 1, 2010.
http://www.hfs.illinois.gov/html/011210n2.html,

Source: IL Dept. of Healthcare and Family Svcs., Handbook for
Practitioners. Ch. A-200 Policy and Procedures, p. 38.

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