MedicaidReimbursementMedium impact
Abortion Services - Rate Increase and Billing Change
Illinois Medicaid - HFS·IL · OB-GYN·Provider Notice
Effective date
Sep 1, 2022
We identified it
Jun 20, 2026
Summary
Illinois Medicaid increased reimbursement rates for abortion procedures effective September 1, 2022, and changed billing requirements for dual Medicare-Medicaid patients effective August 1, 2022. Providers no longer need to bill Medicare first for abortion services for MMAI plan customers.
Action Required
Immediately: Update billing system with new Illinois Medicaid rates for CPT 59840 ($792.00), CPT 59841 ($1,920.00), and HCPCS S0199 ($558.00). For dual Medicare-Medicaid patients receiving abortion services, bill directly to Illinois HFS without requiring Medicare as primary payer. Update billing workflows to bypass Medicare billing for these specific procedures on MMAI plans.