MedicaidBilling CodesHigh impact
Maternity Care Reimbursement Changes Effective October 1, 2023
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine·Provider Notice
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Starting October 1, 2023, providers must bill private insurance first for all maternity services before billing Illinois Medicaid, eliminating the previous 'pay and chase' method. This allows use of global maternity billing codes when patients have primary insurance, but requires individual service coding for Medicaid-only patients with new modifiers.
Action Required
By October 1, 2023: Billing team must update workflows to verify and bill primary insurance carriers BEFORE submitting Medicaid claims for all maternity services. Update billing system to support global maternity billing methodology for patients with TPL and individual service coding with new modifiers for Medicaid-only patients. Review the detailed 'Billing Guidelines for Changes to Maternity Care Reimbursement' document on the Non-Institutional Providers webpage. Contact Bureau of Professional and Ancillary Services at 877-782-5565 for questions on FFS claims.