FAQs on Hospital Professional Billing Transition to the Outpatient Institutional Billing

June 11, 2020


The Illinois Department of Healthcare and Family Services (HFS) has posted a new document, FAQs for Hospital Professional Billing Transition to the Institutional Claim Format.

The FAQs are related to the June 2, 2020 HFS provider notice that all hospital outpatient services billed on a professional claim (HFS 2360/837P) to Non-Institutional Provided Services (NIPS) and paid under the Practitioner Fee Schedule will be billed on an institutional claim (UB-04/837I) and reimbursed under the Enhanced Ambulatory Patient Grouping (EAPG) outpatient methodology, effective for claims with “From” dates on service (DOS) on or after July 1, 2020.  See an IHA memo for more details.

Questions may be submitted in writing to HFS.Hospitals@illinois.gov.