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 a state name in the table below to go to that state's guidance.

 

 

Alabama Idaho
Missouri
Rhode Island
Alaska Illinois  Montana South Carolina 
Arizona Indiana
Nevada
South Dakota
California Iowa
New Hampshire
Tennessee
Colorado  Kansas
New Mexico
Texas
Connecticut Louisiana New York
Utah 
Delaware Maine  North Carolina
Vermont 
District of Columbia Maryland
Ohio
Virginia
Florida Massachusetts
Oklahoma
Washington
Georgia Michigan
Oregon
West Virginia
Hawaii Mississippi
Pennsylvania
Wisconsin

 

* The dates below represent time of publish

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

Alaska
Alaska Department of Health and Social Services – Alaska Medicaid Policy Clarification, Long Acting Reversible Contraception
February 5, 2019

Arizona
Arizona Health Care Cost Containment System: Claims Clues - Long-Acting Reversible Contraception (LARC)
September 2016

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

Colorado
Colorado Department of Health Care Policy & Financing Provider Bulletin B1700400 - Immediate Post-Partum Long-Acting Reversible Contraception (IPP-LARC) “Carve-out” from All Patient Refined-Diagnosis Related Group (APR-DRG) Payment Methodology
July 1, 2017

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

Delaware
Delaware Department of Health and Human Services, Division of Medicaid and Medical Assistance Medicaid Managed Care *See page 95
December 19, 2017
Delaware Department of Health and Human Services, Provider Policy Manual (Fee-for-Service Delivery System) *See page 22
February 1, 2019

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

Florida
Florida Medicaid: Provider Alert - (Clarification) Long-Acting Reversible Contraceptive Inpatient Reimbursement (Fee-for-Service Delivery System)
August 15, 2017

Georgia
Georgia Department of Community Health: Long Acting Reversible Contraceptive (LARC) Devices Provided Immediately Postpartum in a Hospital Setting
April 15, 2014

Hawaii
Hawaii Department of Human Services, Med-QUEST Division: Memorandum - One Key Question and Contraceptive Coverage
November 10, 2016 

Idaho
Idaho Medicaid Management Information System: Provider Handbook *See pages 21-22
September 7, 2017

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

Kansas
Kansas Department of Health and Environment KMAP General Bulletin 18103
May 2018

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

Maine
MaineCare Services: Adopted Rule: Chapters II & III, Section 45, Hospital Services
November 9, 2017

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

Michigan
Bulletin MSA 18-22 Inpatient Long-Acting Reversible Contraception (LARC) Reimbursement
August 31, 2018
Michigan Department of Health and Human Services: Hospital and Professional Providers: Long-Acting Reversible Contraception (LARC)
October 1, 2018

Massachusetts
Massachusetts Office of Medicaid: MassHealth - Payment for In-State Acute Hospital Services and Out-of-State Acute Hospital-Services, effective October 1, 2017 *See pages 7-9
September 28, 2017

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

Nevada
Nevada Department of Health and Human Services: Long-Acting Reversible Contraceptives (LARCs) - Nevada Medicaid Current Procedural Terminology (CPT) code 58300
August 9, 2016

New Hampshire
NH Healthy Families: Postpartum Long-Acting Reversible Contraception Reimbursement Update Effective January 1, 2018
November 30, 2017

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 Mexico Medical Assistance Division: Medical Assistance Program Manual Supplement 19-09 - Medicaid Billing for Long-acting Reversible Contraception (LARC) Products Provided in an Impatient Setting
August 13, 2019

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

North Carolina
North Carolina Division of Medical Assistance: Medical Special Bulletin - Reimbursement of Long Acting Reversible Contraceptives (LARCs)
August 2016

Ohio
Ohio Department of Medicaid: Hospital Handbook Transmittal Letter (HHTL) 3352-17-08 - Reimbursement for Inpatient Postpartum LARC Devices as Required by Sub. S.B. of the 131st General Assembly
June 28, 2017

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, 2016

Rhode Island
Rhode Island Executive Office of Health and Human Services Benefit Clarification Memo: Long Acting Reversible Contraceptives
September 30, 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

Tennessee
TennCare: Memo - Billing Policy Change for Immediate Postpartum Voluntary Long-Acting Reversible Contraception
October 3, 2017

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

Utah
Utah Department of Health - Medicaid: Medicaid Information Bulletin - January 2017 *See page 10
January 1, 2017 

Vermont
Vermont Agency of Human Services: Global Commitment Register - Inpatient Postpartum Long-acting Reversible Contraceptive Add-On
July 26, 2018
Vermont Agency of Human Services: Global Commitment Register - Inpatient Postpartum Long-acting Reversible Contraceptive Add-On
October 31, 2017
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

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

West Virginia
West Virginia Department of Health & Human Resources - Bureau for Medical Services: West Virginia Medicaid Provider Newsletter *See page 5
Qtr. 1 2017

Wisconsin
Wisconsin Department of Health: ForwardHealth Encounter Based Payment Guide
August 1, 2017


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

Last Updated: March 6, 2019


American College of Obstetricians and Gynecologists
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