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October 1 2026 Medically Induced Abortion Services

October 1, 2026: Attention All Providers: The Michigan Department of Health and Human Services (MDHHS) is issuing this Provider Alert to inform all Medicaid providers that beginning on and after October 1, 2026, professional services for medically necessary abortions will be carved out of the Medicaid Health Plans (MHP) and are represented by the following HCPCS codes 59840, 59841, S0190, S0191, and S0199.

Providers should bill professional services directly through the Community Health Automated Medicaid Processing System (CHAMPS) for Fee-for-Service (FFS) reimbursement consideration. When multiple services are provided in conjunction with the indicated HCPCS codes, FFS claims will process for payment of the carved-out service line only; all other claim lines will be denied with Claim Adjustment Reason Code (CARC) 24 – Charges are covered under a capitation agreement/managed care plan. The associated services that are denied by FFS are to be billed to the beneficiary’s health plan for payment.