Medicare Denial Requirement Eliminated for Certain Abortion CPT Codes

Originally published December 30, 2020
Updated on January 4, 2021

Effective for dates of service on or after January 1, 2021, a Medicare denial is no longer required when billing for the following, abortion services, CPT® codes, 59840, 59841, 59850 through 59852 and 59855 through 59857.

A preliminary NewsFlash was released in response to the federal preliminary injunction Civil Action No. TDC 20-1320 regarding the “In-Person requirements contained in the mifepristone REMS as to medication abortion patients, to extend until the resolution of this case or until 30 days after the end of the public health emergency declared by the Secretary of HHS pursuant to 42 U.S.C. § 247d, whichever comes first.”

The Department of Health Care Services (DHCS) is revising the Abortion (abort) section of the Provider Manual to ensure flexibilities exist for providing medically necessary abortion services during the COVID-19 public health emergency.