Reimbursable Service

Covered services are specified in this section and are those that are generally recognized as reasonable and necessary for the diagnosis, care, treatment or rehabilitation of alcoholism and substance abuse as defined in 77 Ill. Adm. Codes 2060 and 2090. NOT all DHS/DASA covered services are reimbursable through the Medical Benefits, All Kids and Family Care. The following services are not covered:

  1. Any service provided to an individual in a federal or state institution;
  2. Residential extended care;
  3. A sanctuary;
  4. A recovery home;
  5. Prevention programs;
  6. Treatment in experimental programs;
  7. Level III Inpatient domiciliary cost for adults in Level III care;
  8. Level III Inpatient domiciliary cost for adolescents in Level III care that is not certified and enrolled as a Psych/Under 21 facility;
  9. The cost of opioid maintenance therapy;
  10. Case Management;
  11. Early Intervention;
  12. Community Intervention;
  13. Toxicology; and
  14. Child Care.

Covered Services

Covered Service Medical Benefits, All Kids and Family Care Reimbursed
Admission and Discharge Assessment Yes
Level I Yes
Level II Yes
Level III.7D (Medically Monitored Detoxification) Yes
Level III.5 (Day Treatment) Yes
Level III.5 (Residential Adolescent Rehabilitation) Yes
Psychiatric/Diagnostic Yes
Medication Monitoring Yes