MedicaidCoverageMedium impact
Expansion of Abortion Reimbursement Effective January 1, 2018
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice·Provider Notice
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
Illinois Medicaid expanded abortion coverage effective January 1, 2018 to include all legal abortions, not just those for life endangerment, rape, incest, or maternal health. All abortion services must now be billed with specific modifiers, including new modifier SE for abortions performed for other reasons.
Action Required
Immediately: Billing team must update system to require modifiers for all abortion claims - U4 (rape), U7 (incest), U8 (life threatening), U9 (health endangering), or SE (other reasons). Update billing rules to include AH condition code for hospital services and require form HFS 2390 with all claims. Claims without proper modifiers will be rejected. For HealthChoice Illinois members, bill expanded coverage services directly to HFS as fee-for-service, not to managed care plan.