Medicaid Reimbursement for Postpartum LARC
The Department of Health and Human Services' Centers for Medicare & Medicaid Services released an 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.
Last Updated March 6, 2019
Find Guidance for Your State
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Alabama
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Alaska
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Arizona
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California
California
- Medi-Cal Diagnosis Related Group Payment Method: Frequently Asked Questions for State Fiscal Year 2018-19 *See pages 24 and 25
July 2018 - County of Los Angeles Public Health: Billing and Reimbursement This document provides further guidance
July 1, 2015
- Medi-Cal Diagnosis Related Group Payment Method: Frequently Asked Questions for State Fiscal Year 2018-19 *See pages 24 and 25
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Colorado
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Connecticut
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Delaware
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
- Delaware Department of Health and Human Services, Division of Medicaid and Medical Assistance Medicaid Managed Care *See page 95
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District of Columbia
District of Columbia
September 22, 2014
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Florida
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Georgia
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Hawaii
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Idaho
Idaho
Idaho Medicaid Provider Handbook: Physician and Non-Physician Practitioner *see page 8
January 1, 2020
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Illinois
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Indiana
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Iowa
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Kansas
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Louisiana
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
- Louisiana Department of Health and Hospitals: Health Plan Advisory 14-9 - Long-Acting Reversible Contraceptives (LARCs) for Inpatient Hospitals
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Maine
Maine
MaineCare Services: Adopted Rule: Chapters II & III, Section 45, Hospital Services
November 9, 2017
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Maryland
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Michigan
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Massachusetts
Massachusetts
September 28, 2017
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Mississippi
Mississippi
July 1, 2016
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Missouri
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Montana
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Nevada
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New Hampshire
New Hampshire
November 30, 2017
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New Mexico
New Mexico
April 1, 2013
August 13, 2019
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New York
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
- New York DOH: Inpatient - Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service
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North Carolina
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Ohio
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Oklahoma
Oklahoma
Oklahoma Health Care Authority: Long Acting Reversible Contraceptive Devices
August 15, 2014
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Oregon
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Pennsylvania
Pennsylvania
Pennsylvania Department of Human Services: MA Fee Schedule **To get to the information, click on Family Planning (FP) Services Fee Schedule, click I Accept on the next page, and then enter the following values: Provider Type – 01, Specialty Code – 010, Place of Service – 22
December 18, 2019
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Rhode Island
Rhode Island
September 30, 2014
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South Carolina
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South Dakota
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Tennessee
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Texas
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Utah
Utah
Utah Department of Health - Medicaid: Medicaid Information Bulletin - January 2017 *See page 10
January 1, 2017
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Vermont
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
- Vermont Agency of Human Services: Global Commitment Register - Inpatient Postpartum Long-acting Reversible Contraceptive Add-On
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Virginia
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Washington
Washington
Washington State Health Care Authority: Family Planning Provider Guide - Immediate Postpartum LARC Insertion *See page 74
April 1, 2016
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West Virginia
West Virginia
Qtr. 1 2017
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Wisconsin
Wisconsin
Wisconsin Department of Health: ForwardHealth Encounter Based Payment Guide
August 1, 2017