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MedicaidBilling CodesMedium impact

Establishment of facility fee for outpatient abortion clinics effective July 1, 2021

Oregon Health Plan·OR · OB-GYN·Provider
Effective date
Jul 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority now allows outpatient abortion clinics to bill for facility costs associated with abortion services using CPT code 99070 with modifiers SU and U4, effective July 1, 2021. This is in addition to existing abortion service reimbursement and applies to eligible providers who don't currently receive facility payments.

Action Required

Action needed
Immediately: Outpatient abortion clinics and family planning clinics should update billing procedures to include CPT code 99070 with modifiers SU and U4 for facility costs associated with abortion services. Submit claim adjustments for previously submitted claims dating back to July 1, 2021 to capture facility fee reimbursement. Reference the Claim Adjustment Handbook for adjustment procedures.

Affected Billing Codes

99070