The Illinois Department of Healthcare and Family Services (HFS) issued an informational notice to announce that Encounter Rate Clinics, Federally Qualified Health Centers and Rural Health Centers can now use procedure code S5190 for a non-physician wellness assessment when an office visit does not meet the requirements for a face-to-face encounter.
No payment for these services will be generated. The purpose of this code is to allow clinics to report quality information such as when a nurse administers an immunization without a physician visit. Utilizing this code will positively affect a clinic's scores on Illinois Health Connect (IHC) Provider Profiles and IHC Bonus Payment for High Performance.
This code should be used instead of T1015 and cannot be used on same claim as T1015.
HFS covered the use of S5190 during a recent IHC webinar. You can locate the information about S5190 on slide 25.
Further questions regarding use of S5190 or the HFS informational notice should be directed to the HFS Bureau of Comprehensive Health Services at 1-877-782-5565.
If you have questions about your IHC Provider Profiles or Bonus Payment, please contact your IHC Quality Assurance Nurse or the IHC Provider Services Help Desk at 1-877-912-1999.
