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Transcervical Fibroid Ablation (TFA) Coverage Effective January 1, 2024

Illinois Medicaid - HFS·IL · OB-GYN·Provider Notice
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid now covers Transcervical Fibroid Ablation (CPT 58580) effective January 1, 2024, as a less invasive treatment for uterine fibroids. The procedure does not require prior authorization for fee-for-service Medicaid but may require it for managed care organizations.

Action Required

Action needed
Immediately: Update billing system to include CPT 58580 as covered for Illinois Medicaid fee-for-service patients. Providers must document specific coverage criteria in medical records including patient age 18-50, fibroid size <7cm, symptoms, and contraindication absence. Contact individual MCOs to verify prior authorization requirements for managed care patients.

Affected Billing Codes

58580