Date: March 2, 2021
To: Enrolled Hospitals: Chief Executive Officers; Chief Financial
Officers; and Patient Accounts Managers
Re: Hospitals Billing as the Telehealth
Originating Site with Revenue Code 0780 and HCPCS Code Q3014
notice provides additional guidance to hospitals billing as the originating
site for outpatient telehealth services. The billing requirements apply to claims
billed under Medicaid fee-for-service as well as HealthChoice
Illinois managed care plans.
outlined in provider notices dated June 2,
2020 and June 24,
2020, effective with service From Dates beginning July 1, 2020, hospitals must bill all services previously billed as
professional (non-hospital) services as outpatient institutional services.
The June 24,
2020, provider notice stated that hospitals must bill Revenue Code 0780 –
Telehealth, General Classification, on the institutional claim format to
designate the telehealth originating site. Additionally, effective with
claims received on and after March 1, 2021, the Department is revising editing
to require HCPCS code Q3014 – Telehealth Originating Site Facility Fee, to be
billed in conjunction with Revenue Code 0780. HCPCS code Q3014 must be
identified on the same revenue line with Revenue Code 0780. If any other
procedure code is billed with Revenue Code 0780, the claim will be rejected
with error code T55 – Missing/Invalid HCPCS for Revenue Code 0780.
services may be billed as necessary on the same outpatient claim with a
telehealth facility fee, but the telehealth service must be identified as
described above. No modifier is required
for the telehealth service.
regarding this notice may be directed to a hospital billing consultant in the
Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable
Illinois managed care plan.
of Medical Programs