Supportive Services Enhancement & Revised Billing Procedure
As IDHS/SUPR continues the transition from an acute SUD care model to a recovery-oriented system of care (ROSC), we want to remove any barriers that might prohibit or prevent the delivery of and reimbursement for SUD supportive services which are often critical to support long term SUD recovery. Therefore, effective immediately, the contract funding billing allowances for case management, early intervention and community intervention have been eliminated.
While delivery of treatment should always be the priority, we recognize the value of supportive service and the increasing need for training and community advocacy activities to build support for the expansion of treatment and recovery support services throughout Illinois. We also want to support the expansion and delivery of recovery support services (RSS) such as employment, peer and recovery coaching, recovery homes, recovery skills, spiritual support, transportation and employment training.
The attached "Revised Billing Procedure" document includes information about supportive services, including recovery support, and how to correctly submit bills for reimbursement. It also includes clarification on income eligibility guidelines, the current payor of last resort policy and information about the IDHS/SUPR Billing Verification Report to ensure accurate billing to the correct payment source.
Examples of acceptable billing activities for case management, early intervention and community intervention are specified in the current Contractual Policy Manual.
Additionally, we will now allow time that staff spend receiving SUPR sponsored training to be billed as community intervention. Recovery support services delivered during treatment can be billed as case management and when delivered pre-treatment and post-discharge billed as community intervention. See the attached billing guide for more information.
We also recognize that currently RSS vary widely in their format and delivery. For this reason, we request that, at a minimum, you adhere to the requirements specified in the attachment if you will be seeking reimbursement for this service.