MedicaidReimbursementHigh impact
Maternity Codes Rate Increases per Public Act 102-1037 and Bonus Payments for Certain Postpartum Visits Effective January 1, 2023
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine·Provider Notice
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Illinois Medicaid increased reimbursement rates for prenatal/postpartum visits and external cephalic version procedures, and introduced $75 bonus payments for timely postpartum visits. Claims are currently being held pending federal approval and system updates.
Action Required
Immediately: For Illinois Medicaid maternity claims, include the actual delivery date in Loop 2300, DTP*454 'Initial Treatment Date' segment on 837P claims to qualify for $75 bonus payments for postpartum visits within 26 days and 27-89 days post-delivery. Monitor for provider notice announcing federal approval and system updates. Prepare to submit replacement claims for services billed prior to this notification that were reimbursed without bonus payments.