US · guidance
CMS Pub. 100-02, ch. 1, § 90
Termination of Pregnancy
B3-4276.1,.2
Effective for services furnished on or after October 1, 1998, Medicare will cover
abortions procedures in the following situations:
1. If the pregnancy is the result of an act or rape or incest; or
2. In the case where a woman suffers from a physical disorder, physical injury, or
physical illness, including a life-endangering physical condition caused by the
pregnancy itself that would, as certified by a physician, place the woman in
danger of death unless an abortion is performed.
NOTE: The "G7" modifier must be used with the following CPT codes in order for
these services to be covered when the pregnancy resulted from rape or incest, or the
pregnancy is certified by a physician as life threatening to the mother:
59840 59841 59850
59851 59852 59855
59856 59857 59866
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
f2e9b1e4120ce43d9500515c3fea7581db3c8486076316749ff50592e07990e1
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