89 Ill. Adm. Code 140.538
Special Costs
Section 140
Section 140.538 Special
Costs
a) Transportation – The costs of transportation that is medically
necessary and is of the type reimbursed by Public Aid in addition to the
routine rate is not allowable. Other types of patient related transportation
costs should be classified as either administrative costs or activity costs and
are allowable.
b) Ancillary Services – are not an allowable expenditure.
Ancillary services are those services which are not explicitly required by
licensing requirements. Accordingly, the definition of ancillary service
differs by licensure type, particularly between SNF and ICF, as compared to
ICF/MR facilities.
c) For SNF or ICF, the following are ancillary services:
occupational therapy by a licensed therapist, recreational therapy by a
licensed therapist, dental care, work-related programs, rehabilitation by
licensed personnel, pharmacy (other than "group care restricted"),
psychological services (evaluation and diagnosis/behavior modification), and
academic education by licensed personnel.
d) These services, when offered by the above practitioners are
ancillary services whether they are offered in the facility or outside the
facility. Note, this does not include consultants or services offered by
unlicensed personnel within the facility even if they relate to the above program
areas.
e) In an ICF/MR or SNF Pediatric facility the following services
are ancillary: physician care, dental care – except for dental screening,
work-related programs (other than Level I Developmental Training and Level II
Developmental Training as defined in Section 140.647, Description of Day
Programming Service Levels), pharmacy (other than "group care
restricted"), academic education, and any service for which the individual
practitioner bills the Department directly or any service for which the
Provider directly bills another Department or another governmental unit,
including local school districts.
f) It is the responsibility of the individual provider to obtain
prior approval before rendering ancillary services. Ancillary providers must
be enrolled with the Department.
g) Oxygen in excess of one tank per patient per month is
reimbursed directly rather than as part of the per diem. In order to submit
claims the facility must be enrolled as a provider of oxygen.
h) Barber and Beauty Shops – Costs associated with barber and
beauty shops are not allowable.
i) Coffee and Gift Shops – Costs associated with coffee and gift
shops are not allowable.
j) Assessment fees required by Public Act 87-861 or Public Act
88-88 to be paid to the Department of Public Aid are not an allowable cost for
reimbursement purposes. This fee must be reported on the cost report Schedule
V, Section E, Special Cost Centers, Line 42.