MedicaidCoverageMedium impact
Payment for Essure Micro-inserts
Illinois Medicaid - HFS·IL · OB-GYN·Provider Notice
Effective date
Jan 1, 2008
We identified it
Jun 21, 2026
Summary
Illinois Medicaid has expanded coverage for Essure Micro-inserts for female sterilization performed in physician offices. Providers must bill CPT code 99070 with product name in description field for $1,245.00 reimbursement and submit required sterilization consent forms.
Action Required
Immediately: Billing team must update system to bill CPT code 99070 for Essure Micro-inserts with product name in description field. Ensure HFS 2189 Sterilization Consent Form is completed and submitted with insertion procedure claims. For Illinois Healthy Women program participants, include appropriate V25 series diagnosis codes to indicate family planning purposes.