Section 148.115  Reimbursement Methodologies for Long Term Acute Care Services

Effective with discharges on or after July 1, 2014:

a)         Inpatient long term acute care psychiatric services excluded from the DRG PPS pursuant to 89 Ill. Adm. Code 149.50(b) shall be reimbursed under the inpatient psychiatric services methodologies specified in Section 148.110.

b)         Inpatient long term acute care services excluded from the DRG PPS shall be reimbursed a hospital-specific rate paid per day of covered inpatient care, determined pursuant to this Section.  The total payment for an inpatient stay will equal the sum of:

1)         the payment determined in this Section; and

2)         any applicable adjustments to payment specified in Section 148.290.

c)         Payment for long term acute care services provided by a long term acute care hospital, as defined in Section 148.25(d)(4):

1)         That was not enrolled with the Department on December 31, 2023, shall be the product of the following:

A)        $800.16; and

B)        The length of stay, as defined in 89 Ill. Adm. Code 149.100(i).

2)         That was enrolled with the Department on December 31, 2023, shall be the product of the following:

A)        The rate in effect on December 31, 2023 multiplied by 1.1; and

B)        The length of stay, as defined in 89 Ill. Adm. Code 149.100(i).

(Source:  Amended at 49 Ill. Reg. 2024, effective February 10, 2025)