Who is affected by this change?

This affects Illinois Medicaid - HFS OB-GYN, Family Medicine, General Practice providers in IL on Medicaid plans.

When does this change take effect?

This change is effective May 11, 2022.

Which billing codes are affected?

The following codes are affected: S0199, S0190, S0191.

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MedicaidAdministrativeMedium impact

Abortion Services

Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice·Provider Notice

Effective date

May 11, 2022

We identified it

Jun 20, 2026

Days to comply

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Summary

Illinois providers must bill all abortion services directly to the state Department (not through managed care plans) for both fee-for-service and managed care enrollees. The policy clarifies specific procedure codes and billing requirements for surgical and medication-assisted abortions under Illinois' freedom of choice law.

Action Required

Action needed

Immediately: Illinois providers must update billing workflows to submit all abortion service claims directly to the Illinois Department of Healthcare and Family Services, bypassing managed care plans. Update billing system to route abortion procedure codes (S0199, S0190, S0191) to state billing rather than managed care. Train billing staff on 837 Professional and Institutional claim submission requirements for abortion services.

Affected Billing Codes

S0199

S0190

S0191

Related policy hubs

Illinois Medicaid - HFS policies IL policy changes OB-GYN Family Medicine General Practice Code S0199 Code S0190 Code S0191