Refer to the Medicine and Surgery section of the Physician Handbook for more information on Wisconsin Medicaid coverage of surgical or medical abortions or abortion-related procedures. Under federal law, only physicians may obtain and dispense Mifeprex. For the third visit, use the evaluation and management code that reflects the service provided. Attach to each claim a completed abortion certification statement that includes information showing that the situation is one in which Medicaid covers abortion. Refer to Appendix 10 of the Medicine and Surgery section of the Physician Handbook for an example of a statement form.
Complications related to abortions are separately reimbursable.
If you are a Medicaid HMO network provider, contact your managed care organization for more information about its billing procedures. The Wisconsin Medicaid and BadgerCare Update is the first source of program policy and billing information for providers. Although the Update refers to Medicaid recipients, all information applies to BadgerCare recipients also. Wisconsin Medicaid and BadgerCare are administered by the Division of Health Care Financing, Wisconsin Department of Health and Family Services, P.O . Box 309, Madison, WI 53701-0309.