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MedicaidReimbursementMedium impact

Dispensing Fee Add-on for Certain Birth Control Methods

Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Days to comply

Summary

A $20 dispensing fee add-on is now available for specific birth control methods purchased through the 340B Drug Pricing Program when billed with modifier UD. This applies to various contraceptive devices, injections, and medications including IUDs, implants, patches, and oral contraceptives.

Action Required

Action needed
Immediately: Billing team must add modifier 'UD' to all listed birth control method codes when drugs are purchased through 340B program. Bill actual acquisition cost only - do NOT add the $20 dispensing fee to your charges as the department will automatically add this to reimbursement. For J3490 (Skyla IUD), include the item name in the note/description field.

Affected Billing Codes

A4266
J1050
J1055
J3490
J7300
J7302
J7303
J7304
J7307
S4993