MedicaidCoverageMedium impact
Chapter H-200, Handbook for Hospital Services Reimbursement for APL Services Performed at Hospital-Owned Off-Site Clinics
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jun 15, 2011
We identified it
Jun 21, 2026
Summary
Illinois Medicaid has removed the requirement that APL (Ambulatory Procedures Listing) services be performed on or adjacent to hospital premises. Hospitals can now bill for APL procedures performed at off-site clinics, but the clinic must be within a 35-mile radius of the main hospital.
Action Required
Immediately: Hospital billing teams should review current APL procedure claims to identify services performed at off-site clinics within 35 miles of the main hospital that may now be billable. Update billing protocols to allow APL procedure claims from qualifying off-site locations. Download updated Handbook for Hospital Services from the Illinois Department of Healthcare website and replace specified handbook pages per the detailed instructions provided.