Immediate Postpartum LARC Medicaid Reimbursement

The Department of Health and Human Services' Centers for Medicare & Medicaid Services released this Informational Bulletin on April 8, 2016, detailing payment and policy approaches several state Medicaid agencies have used to optimize access and use of long-acting reversible contraception (LARC) methods.

Medicaid Reimbursement for Postpartum LARC in the Hospital Setting

States in light blue on the map below have published guidance regarding reimbursement for postpartum LARC - click on them for more information.

state map

The following states have published guidance regarding reimbursement for immediate postpartum LARC:

  Alabama Georgia
Louisiana
New Mexico
South Carolina
  California Illinois
Maryland
New York
Texas
  Colorado  Indiana
Missouri
Ohio
Vermont
  Connecticut  Iowa
Montana
Oklahoma
Washington 
  District of Columbia

 
 

Alabama
Alabama Medicaid Agency: All Hospitals and All Physicians Alert - Long Acting Reversible Contraception (LARC)
March 19, 2014

California
Medi-Cal: Medi-Cal Update - Inpatient Claims for Long-Acting Reversible Contraceptives *See item 8
June 2015

Colorado
Colorado HCPF: Provider Bulletin - All Patient Refined-Diagnosis Related Group (APR-DRG) and Immediate Post-Partum Long-Acting Reversible Contraception (PP-LARC) Update *See page 9
January 2016

Connecticut
Connecticut Medical Assistance Program: Provider Bulletin - Hospital Billing and Reimbursement for Immediate Postpartum Long-Acting Reversible Contraceptive Products
April 2016

District of Columbia
District of Columbia Department of Health Care Finance: Transmittal 14-24 - Medicaid Coverage of Long Acting Reversible Contraception
September 22, 2014

Georgia
Georgia Department of Community Health: Long Acting Reversible Contraceptive (LARC) Devices Provided Immediately Postpartum in a Hospital Setting
April 15, 2016

Illinois
Illinois Healthcare and Family Services: Provider Notice - Hospital Billing and Reimbursement for Immediate Postpartum Long-Acting Reversible Contraceptives Effective July 1, 2015
June 30, 2015

Indiana
Indiana Health Coverage Programs: Banner Page - The IHCP to Allow Separate Reimbursement for LARC Devices Implanted During Delivery Stay
April 28, 2015

Iowa
Iowa Department of Human Services: Informational Letter No. 1349 - Long Acting Reversible Contraception (LARC)
February 3, 2014

Louisiana

Maryland
Maryland DHMH: Clinician Letter - LARC
September 24, 2014

Missouri
MO HealthNet Division: Provider Bulletin Volume 38 Number 42 - LARC Devices Inserted Post-Partum During an Inpatient Hospital Stay
May 11, 2016

Montana
Montana DPHHS: Montana Health Care Programs Notice (Hospital Inpatient) - Long Acting Reversible Contraception (LARC) Inserted at Time of Delivery in a PPS Hospital
January 9, 2014

New Mexico
New Mexico Medical Assistance Division: Medical Assistance Program Manual Supplement 13-05 - Insertion of Long Acting Reversible Contraceptives at Time of an Inpatient Delivery Stay
April 1, 2013

New York

Ohio
Ohio Department of Medicaid: Office of Benefits Hospital Billing Guidelines - Long Acting Reversible Contraceptives *See page 34

Oklahoma
Oklahoma Health Care Authority: Long Acting Reversible Contraceptive Devices
August 15, 2014

South Carolina

Texas
Texas HHSC: Reimbursement Methodology to Change for Long-Acting Reversible Contraceptive (LARC) Devices Effective January 1, 2016
December 31, 2015

Vermont

Washington
Washington State Health Care Authority: Family Planning Provider Guide - Immediate Postpartum LARC Insertion *See page 74
April 1, 2016

 

Please forward any corrections, updates, or newly published guidance to Mica Bumpus at MBumpus@acog.org 

Last Updated: August 3, 2016


American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998