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
Last Updated June 30, 2020
Find Guidance for Your State
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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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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
September 22, 2014
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Idaho
Idaho Medicaid Provider Handbook: Physician and Non-Physician Practitioner *see page 8
January 1, 2020
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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
MaineCare Services: Adopted Rule: Chapters II & III, Section 45, Hospital Services
November 9, 2017
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Massachusetts
September 28, 2017
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New Hampshire
November 30, 2017
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New Mexico
April 1, 2013
August 13, 2019
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New York
- New York State Department on Health: Medicaid Update, March 2017
- Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Postpartum Service (Midwife), May 2014
- Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Postpartum Service (Physician), May 2014
- Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Postpartum Service (Inpatient), May 2014
- Clarification on Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service, April 2015
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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 Executive Office of Health and Human Services: Medicaid Fee Schedules
February 2020
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Utah
Utah Department of Health - Medicaid: Medicaid Information Bulletin - January 2017 *See page 10
January 1, 2017
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Virginia
Virginia Department of Medical Assistance Services - Medicaid Provider Manual Update
January 2017
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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
Qtr. 1 2017
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Wisconsin
Wisconsin Department of Health: ForwardHealth Encounter Based Payment Guide
April 10, 2020