MedicaidBilling CodesMedium impact
Billing Changes to Dispensing Fee Add-on for Certain Birth Control Methods
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice·Provider Notice
Effective date
Feb 4, 2014
We identified it
Jun 20, 2026
Summary
Providers billing 340B birth control drugs must now include modifier 'UD' and add the $20 dispensing fee to their charge amount to receive proper reimbursement. Previous claims missing the dispensing fee can be adjusted retroactively to July 1, 2012.
Action Required
Immediately: Billing team must update all future 340B birth control drug claims to include modifier 'UD' and add $20 dispensing fee to provider charge (acquisition cost + $20). For previous underpaid claims, submit Bill Type '7' replacement claims or paper HFS 2292 NIPS Adjustment forms to void and re-bill with correct amounts. Contact department at 1-877-782-5565 for claims older than 180 days requiring timely filing override.