MedicaidBilling CodesHigh 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
Illinois Medicaid introduced two new HCPCS codes for prenatal services: 0500F for initial visits (requires reporting last menstrual period) and 0502F for subsequent visits. Starting May 1, 2005, providers can use these codes instead of E&M codes with TH modifiers to receive enhanced prenatal care reimbursement rates.
Action Required
Immediately: Update billing system to use HCPCS code 0500F for initial prenatal visits and 0502F for subsequent visits. Configure system to require last menstrual period (LMP) reporting in Loop 2300 for 837P claims or Field 23D for DPA 2360 forms when billing 0500F. Train billing staff to stop using E&M codes with TH modifier for routine prenatal care after May 1, 2005.