MedicaidCoverageLow impact
Preeclampsia Biomarker Testing per Public Act 104-0470
Illinois Medicaid - HFS·IL · OB-GYN·Provider Notice
Effective date
Jan 1, 2022
We identified it
Jul 22, 2026
Summary
The Illinois Department of Healthcare and Family Services confirms Medicaid coverage of preeclampsia biomarker testing (CPT codes 0243U, 0390U, and 0524U) without cost-sharing requirements under Public Act 104-0470. Coverage has been active since January 1, 2022 for both fee-for-service and managed care organizations. This is a clarification notice confirming existing coverage; no new billing code changes are required.
Action Required
No immediate action required. The billing team should verify that CPT codes 0243U, 0390U, and 0524U are configured in the billing system to bill Illinois Medicaid (both FFS and MCO plans) without requiring patient cost-sharing (deductible, coinsurance, copayment). If these codes are not currently in use at the practice, no changes are needed. For questions or if preeclampsia biomarker testing begins being offered, contact the Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable MCO.