MedicaidCoverageMedium impact
Medical Abortion Procedure: Termination of Early Pregnancy with Mifepristone
Maryland Medicaid·MD · OB-GYN, Family Medicine·General Provider
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program now covers medical abortion using mifepristone (Mifeprex) for early pregnancy termination up to 49 days. Billing requires CPT code 99199 with specific documentation and certification requirements.
Action Required
For Maryland Medicaid patients: Use CPT code 99199 for medical abortion procedures. Write 'Medical Abortion' in Block 24D of HCFA-1500. Use diagnosis codes 635 or 638 in Block 21. Attach completed Certification of Abortion DHMH 521 form. Bill Medicaid directly even for MCO patients. Fee is $401 for office/clinic setting, $300 for hospital outpatient professional component.