MedicaidBilling CodesMedium impact
Subsequent Healthy Newborn Visits
Illinois Medicaid - HFS·IL · Pediatrics, OB-GYN, Family Medicine·Provider Notice
Effective date
Sep 1, 2007
We identified it
Jun 21, 2026
Summary
The fee schedule has been updated to allow reimbursement for subsequent hospital visits to healthy newborns whose mothers cannot be discharged. Initial healthy newborn visits use CPT 99431, while subsequent visits use CPT 99433.
Action Required
Billing team must update coding protocols to use CPT 99431 for initial healthy newborn visits and CPT 99433 for subsequent healthy newborn hospital visits when mothers cannot be discharged. Newborns with complications require subsequent hospital care codes or neonatal/pediatric critical care codes instead.