MedicaidReimbursementMedium impact
Updated Guidance on the Use of Misoprostol
Maryland Medicaid·MD · OB-GYN·Provider Transmittal
Effective date
Feb 1, 2022
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now allows reimbursement for Misoprostol (S0191) billed on the same date of service as surgical abortion procedures (CPT 59840 or 59841), reversing previous guidance that prohibited same-day billing. This change is effective February 1, 2022, and applies to all providers billing Maryland Medicaid for abortion services.
Action Required
By February 1, 2022: Billing team must update billing system logic to allow concurrent billing of S0191 with CPT 59840 or 59841 on the same date of service for Maryland Medicaid claims. Review and update any internal billing rules, edits, or claim submission protocols that previously prevented same-day billing of these codes together. Notify providers and clinical staff that Misoprostol can now be billed alongside surgical abortion procedures. Failure to update billing rules may result in unnecessary claim denials or manual intervention on previously allowable claims.