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MedicaidCoverageMedium impact

Licensed Certified Professional Midwives Enrollment and Billing per Public Act 103-0720

Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine·Claims & Billing
Effective date
May 1, 2026
We identified it
Jun 16, 2026
Days to comply

Summary

Illinois Medicaid now covers Licensed Certified Professional Midwife (LCPM) services effective May 1, 2026, allowing LCPMs to enroll and bill for maternity care services. This applies to both Medicaid fee-for-service and HealthChoice Illinois managed care organizations.

Action Required

Action needed
By May 1, 2026: Illinois practices working with LCPMs must update billing systems to include taxonomy code 176B00000X for LCPM services. Add CPT 59430 postpartum visit billing with delivery date tracking in Loop 2300, Segment DTP*454 for incentive payments. Ensure LCPM providers enroll in IMPACT system and obtain NPIs before billing.

Affected Billing Codes

59430