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Remote Patient Monitoring Illinois

Illinois Medicaid will cover home uterine monitoring with prior approval and when patient meets specific criteria. Payment is only for the items and not for the service.


Source: IL Dept. of Healthcare and Family Services, Handbook for Durable Medical Equipment, Chapter M-200, Policy and Procedures for Medical Equipment and Supplies, p. 56 (Sept. 2015). (Accessed Sept. 2019). 


Conditions


Only for home uterine monitoring.


Home uterine monitoring


• Must be at least 24 weeks gestation; gestation of less than 24 weeks may require additional information
• Hospitalized for preterm labor at 24-36 weeks
• Cessation of labor accomplished by administration of tocolytics (terbutaline, procardia, etc.)
• Discharged to home on oral or subcutaneous tocolytics
• Multiple gestation pregnancy
• History of preterm labor and delivery
• Cervical status change (lengthening or dilation)
• Cervical effacement
• Contraction threshold
• Gravida/para

Pregnancy-Induced Hypertension Monitor


• Covered for diagnosis of pregnancy-induced hypertension, previous pregnancy induced hypertension or pre-eclampsia
• Hospitalizations for symptoms related to pregnancy induced; i.e., hypertension, headaches, edema in face, hands and feet
• Blurred vision
• Right upper quadrant pain
• 24-hour urine results greater than 300 mg of total protein
• Antihypertensive medications
• Pre-pregnancy and current blood pressure readings.


Will not be covered for patients with a diagnosis of chronic hypertension.


Source: IL Dept. of Healthcare and Family Services, Handbook for Durable Medical Equipment, Chapter M-200, Policy and Procedures for Medical Equipment and Supplies, p. 56 (Sept. 2015). (Accessed Sept. 2019).