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

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

Hawaii
Hawaii Department of Human Services, Med-QUEST Division: Memorandum - One Key Question and Contraceptive Coverage
November 10, 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

Pennsylvania
Pennsylvania Department of Medicaid: Medical Assistance Bulletin - MA Program Fee Schedule Updates for Certain Family Planning Services
November 26, 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: November 29, 2016


American Congress of Obstetricians and Gynecologists
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