Date: September 24, 2021
To: All Medical Assistance Program Providers
Re: Confirmation of Reimbursement for Epilepsy Specialists via Telehealth per Public Act 102-0207
This notice confirms the Department's coverage for epilepsy treatment services via telehealth as required under Public Act 102-0207. Coverage is provided under both Medicaid fee-for-service and the managed care plans.
The Act requires the Department to reimburse epilepsy specialists who are authorized by Illinois law to provide epilepsy treatment services to persons with epilepsy or related disorders via telehealth. Epilepsy specialists are licensed physicians who have obtained additional training and qualifications and are defined by their respective specialties and the American Board of Medical Specialties. Licensed physicians are defined in the Medical Practice Act. All Illinois licensed physicians, including epilepsy specialists, who meet the requirements under 89 Ill. Admin. Code Section 140.403 – Telehealth Services may bill a service via telehealth.
Questions regarding this notice may be directed to a billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable managed care plan.
Kelly Cunningham, Administrator
Division of Medical Programs