Section 148.116  Reimbursement Methodologies for Children's Specialty Hospitals

Effective for dates of outpatient services on or after July 1, 2014 and inpatient discharges on or after July 1, 2014:

a)         Inpatient general acute care services provided by a children's specialty hospital located in Illinois, as defined in Section 148.25(i) and excluded from the DRG PPS pursuant to 89 Ill. Adm. Code 149.50(b), shall, per day of covered inpatient care, be reimbursed as follows:

1)         For a hospital that would not have met the definition of a children's specialty hospital as of July 1, 2013, $1,400.00 per day.

2)         For a hospital or a cost reporting hospital located outside of Illinois that would have met the definition of a children's specialty hospital as of July 30, 2023, a rate equal to $2,003.13.

3)         The total payment for inpatient stay will equal the sum of:

A)        The payment determined in this subsection; and

B)        Any applicable adjustments to payment specified in Section 148.290.

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