103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB3977

 

Introduced 2/21/2023, by Rep. Lindsey LaPointe

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-47 new

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for purposes of preventing a potential mental health diagnosis when mental health symptoms are present and to enable early treatment, Therapy and Counseling - Brief Intervention Services (Code H0004 TF TL) shall be covered under the medical assistance program for children under 21, and for adults ages 21 and older, who are otherwise eligible for medical assistance. Provides that completion of an Integrated Assessment and Treatment Planning service shall not be required (given the short duration of services). Provides that, at a minimum, up to 8 clinical sessions not to exceed 90 minutes per session shall be permitted. Provides that such services shall be permitted to be delivered by a licensed practitioner of the healing arts; or a qualified mental health professional or mental health professional under the direction of a licensed practitioner of the healing arts. Sets forth certain billing codes that must be used when billing for therapy and counseling services. Requires the Department of Healthcare and Family Services to apply for federal approval if necessary. Grants the Department rulemaking authority. Effective immediately.


LRB103 26962 KTG 53327 b

 

 

A BILL FOR

 

HB3977LRB103 26962 KTG 53327 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5adding Section 5-47 as follows:
 
6    (305 ILCS 5/5-47 new)
7    Sec. 5-47. Mental health prevention services for children
8and adults. For purposes of preventing a potential mental
9health diagnosis when mental health symptoms are present and
10to enable early treatment, Therapy and Counseling - Brief
11Intervention Services (Code H0004 TF TL) shall be covered
12under the medical assistance program for children under 21,
13and for adults ages 21 and older, who are otherwise eligible
14for medical assistance. Such services shall be deemed to be
15medically necessary when performed for the immediate
16amelioration of an individual's presenting clinical issues,
17meaning a mental health diagnosis is not required for such
18services. Completion of an Integrated Assessment and Treatment
19Planning service shall not be required (given the short
20duration of services). At a minimum, up to 8 clinical sessions
21not to exceed 90 minutes per session shall be permitted. Such
22services shall be permitted to be delivered by a licensed
23practitioner of the healing arts; or a qualified mental health

 

 

HB3977- 2 -LRB103 26962 KTG 53327 b

1professional or mental health professional under the direction
2of a licensed practitioner of the healing arts.
3        (1) Coding. The following credentialed individuals
4    shall bill for therapy and counseling - brief intervention
5    using the following codes:
6            (A) Licensed practitioners of the healing arts
7        shall bill under Code H0004 TF TL.
8            (B) Qualified mental health professionals shall
9        bill under Code H0004 HO TL.
10            (C) Mental health professionals shall bill under
11        Code H0004 HN TL.
12        (2) Federal approval and rulemaking authority. If the
13    Department of Healthcare and Family Services determines
14    that federal approval is required for implementation of
15    this Section, an application for federal approval shall be
16    filed within 3 months after the effective date of this
17    amendatory Act of the 103rd General Assembly. If the
18    Department determines an administrative rule change is
19    necessary for purposes of this Section, such rule shall be
20    adopted within 6 months after the effective date of this
21    amendatory Act of the 103rd General Assembly or, if
22    necessary, within 6 months after the Department receives
23    federal approval, whichever comes last.
 
24    Section 99. Effective date. This Act takes effect upon
25becoming law.