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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
Days to comply

Summary

New billing requirements for Mifepristone (abortion medication) clarify that providers must use procedure code H0033 with specific U modifiers and bill a global rate of $118.10 for the three required office visits. Providers must also submit form HFS 2390 and continue billing individual drugs separately.

Action Required

Action needed
Immediately: Billing team must configure system to use procedure code H0033 with appropriate U modifiers (U4, U7, U8, U9) for Mifepristone procedures. Set global rate at $118.10 with quantity of 1. Ensure HFS 2390 form is submitted with all claims. Continue billing Mifepristone and Misoprostol drugs separately under their HCPCS codes.

Affected Billing Codes

H0033