MedicaidBilling CodesMedium impact
Billing Requirements for Mifepristone
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine·Provider Notice
Effective date
Dec 15, 2005
We identified it
Jun 21, 2026
Summary
This policy clarifies billing requirements for Mifepristone termination procedures, requiring use of procedure code H0033 with specific U modifiers (U4, U7, U8, U9) to identify the reason for termination. Providers receive a global payment of $118.10 for all three required visits and must submit form HFS 2390 with claims.
Action Required
Immediately: Billing team must configure system to use procedure code H0033 with appropriate U modifiers (U4-rape, U7-incest, U8-life threatening, U9-health endangering) for Mifepristone procedures. Set quantity to '1' for the three-visit package. Ensure HFS 2390 Abortion Payment Application is completed and submitted with all claims. Continue billing Mifepristone and Misoprostol drugs separately under their HCPCS codes.