Medicaid Reimbursement for Postpartum LARC by State

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 Hawaii
Mississippi Oklahoma
Vermont
  California Illinois
Missouri
Oregon
Virginia
  Colorado  Indiana
Montana
Pennsylvania
West Virginia
  Connecticut  Iowa
New Mexico
South Carolina
Washington
  District of Columbia Louisiana
New York
South Dakota

  Georgia
Maryland
Ohio
Texas
 

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
Louisiana Department of Health and Hospitals: Health Plan Advisory 14-9 - Long-Acting Reversible Contraceptives (LARCs) for Inpatient Hospitals
Revised May 25, 2016
Louisiana Bureau of Health Services Financing: Hospital Services Provider Manual *See document section 25.2 page 10
July 1, 2011

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

Mississippi
Mississippi Division of Medicaid: Mississippi Medicaid Provider Reference Guide For Part 221 - Family Planning and Family Planning Related Services *See page 4
July 1, 2016

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
New York DOH: Inpatient - Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service
May 28, 2014
New York DOH: Midwife - Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service
May 28, 2014
New York DOH: Nurse Practitioner - Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service
May 28, 2014
New York DOH: Physician - Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service
May 28, 2014

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

Oregon
Oregon Health Authority: Health Evidence Review Commission (HERC) Coverage Guidance - Timing of Long-Acting Reversible Contraceptive (LARC) Placement
November 10, 2016
Oregon Health Authority: Health Evidence Review Commission (HERC) Letter to Medical Directors - LARC Implementation
November 10, 2016

Pennsylvania
Pennsylvania Department of Medicaid: Medical Assistance Bulletin - MA Program Fee Schedule Updates for Certain Family Planning Services
November 26, 2014

South Carolina
South Carolina HHS: Medicaid Bulletin - Long Acting Birth Control Device Provided in a Hospital Setting
January 29, 2012
South Carolina HHS: Medicaid Bulletin - Clarification Bulletin; Long Acting Reversible Contraceptives Provided in an Inpatient Hospital Setting
August 13, 2013

South Dakota
South Dakota Division of Medical Services: South Dakota Medicaid Institutional Billing Manual - March 2017 *See page 26
March 2017

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

Vermont
Vermont Agency of Human Services: Global Commitment Register - Inpatient Postpartum Long-acting Reversible Contraceptive Add-On
April 29, 2016
Vermont Agency of Human Services: Global Commitment to Health Quarterly Report for Q1 2016 *See page 5
May 31, 2016

Virginia
Virginia Department of Medical Assistance Services: Medicaid Memo - Long Acting Reversible Contraceptives (LARC) Payment in an Inpatient Hospital for Members in Medicaid and FAMIS Fee-for-Service Programs and Managed Care Organizations–Effective for Dates of Service on or after January 1, 2017
December 1, 2016

West Virginia
West Virginia Postpartum LARC Toolkit: A Resource for Providing Long-Acting Reversible Contraceptive (LARC) Services in the Hospital Postpartum Setting

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: June 2, 2017


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