MedicaidBilling CodesMedium impact
Reimbursement for Birth Control Pills
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice·Provider Notice
Effective date
Jan 1, 2006
We identified it
Jun 21, 2026
Summary
Starting January 1, 2006, birth control pills will be system-priced at $1.35 per pill instead of hand-priced, eliminating claim suspensions. Providers must use specific billing codes: S4993 for regular birth control pills and J8499 for Plan B/Preven Kit, with required NDC reporting.
Action Required
By January 1, 2006: Billing team must update system to use code S4993 for birth control pills (max 3-month supply) and J8499 for Plan B/Preven Kit. Include NDC codes per June 16, 2005 notice requirements. Update billing software to reflect $1.35 per pill reimbursement rate and ensure exact quantity is reported in days/units field.