MedicaidBilling CodesMedium impact
New Procedure Codes for Prenatal Services
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine·Provider Notice
Effective date
Jan 1, 2005
We identified it
Jun 21, 2026
Summary
New HCPCS codes 0500F and 0502F are now available for prenatal services billing with enhanced reimbursement rates. Starting May 1, 2005, providers no longer need to use E&M codes with TH modifiers for enhanced prenatal care reimbursement.
Action Required
By May 1, 2005: Update billing system to use HCPCS code 0500F for initial prenatal visits and 0502F for subsequent prenatal visits instead of E&M codes with TH modifiers. Configure system to require LMP reporting in Loop 2300 for 837P claims or Field 23D for DPA 2360 forms when billing 0500F. For pregnancy complications, continue using appropriate E&M codes with complication as primary diagnosis and pregnancy as secondary.