MedicaidReimbursementMedium impact
Rate Increase for Breast Tomosynthesis Procedures Effective January 1, 2023, per Public Act 102-1018
Illinois Medicaid - HFS·IL · Radiology, OB-GYN·Provider Notice
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Medicaid increased reimbursement rates for breast tomosynthesis procedures (G0279 and 77063) to $56.06 effective January 1, 2023. Providers can submit replacement claims for any procedures already reimbursed at the old lower rate.
Action Required
Immediately: Billing team should verify current reimbursement rates for breast tomosynthesis procedures G0279 and 77063 are set to $56.06 for Medicaid FFS and HealthChoice Illinois MCOs. Submit replacement claims following Chapter 300 Companion Guide instructions for any claims already processed at the old rate to receive the increased reimbursement.