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Abortion Rates Increase

November 10, 2017

Effective for dates of service on or after July 1, 2017, the Department of Health Care Services (DHCS) will increase reimbursement rates for the following Current Procedural Terminology – 4th Edition (CPT-4) codes:

CPT-4 Code Description New Reimbursement Rate
59840 Induced abortion, by dilation and curettage $399.99
59841 Induced abortion, by dilation and evacuation $699.92

The DHCS Fiscal Intermediary (FI) will initiate an Erroneous Payment Correction to reexamine affected claims to determine if the billed usual and customary charges result in an adjustment to the reimbursement rates. Providers should continue to submit claims in a timely manner.