Clinical Practice: Expanding Coverage and Reimbursement for Immediate Postpartum LARC

Reports of increased demand for IUDs have surfaced amid concerns over the changing and uncertain health insurance landscape. This highlights the importance of maintaining momentum behind efforts to increase access to long-acting reversible contraceptive methods (LARC), including in the immediate postpartum setting. While some institutions are offering immediate postpartum LARC, many others continue to experience barriers to postpartum LARC provision, including difficulty receiving reimbursement from both public and commercial payers.

As of February 2017, the ACOG LARC Program has identified 26 states with published guidance on reimbursement for immediate postpartum LARC through their state Medicaid program.

In September 2016, the Kaiser Family Foundation published the results of its Medicaid Coverage of Family Planning Benefits Survey, which found that states are considering and implementing various reimbursement structures for postpartum LARC insertion. The survey report outlines how 41 states currently reimburse for postpartum LARC insertion.

There are also efforts to advocate for similar policies from commercial payers, including reimbursement separate from the global fee for LARC methods provided immediately postpartum. The CDC’s 6/18 initiative, a partnership between purchasers, payers, and providers, has identified insurance coverage of immediate postpartum LARC as a way to positively impact both health and costs. The initiative is working to ensure that both public and private payers reimburse for immediate postpartum LARC insertion by unbundling payment for LARC from other postpartum services.

The ACOG LARC Program has numerous advocacy and policy resources to assist in efforts to expand coverage and reimbursement for LARC, such as Intrauterine Devices and Implants: A Guide to Reimbursement and NICQH: Strategies to Increase LARC in Medicaid.

We hope these resources are helpful as you continue to advocate for payment policies that improve women’s access to the full range of contraceptive methods. As always, you can find more LARC-related clinical, patient, and practice resources on the ACOG website at 

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998