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 April 2022
Find Guidance for Your State
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Alaska
Alaska Department of Health and Social Services – Alaska Medicaid Policy Clarification, Long Acting Reversible Contraception
February 5, 2019 -
California
Medi-Cal Diagnosis Related Group Payment Method: Frequently Asked Questions for State Fiscal Year 2018-19 *See pages 24 and 25
July 2018County of Los Angeles Public Health: Billing and Reimbursement This document provides further guidance
July 1, 2015 -
Colorado
Colorado Department of Health Care Policy & Financing: Provider Bulletin
January 2020 -
Delaware
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 -
Georgia
Clinical Policy: Long Acting Reversible Contraception (LARC) Devices
September 2020Clinical Policy: Long Acting Reversible Contraception (LARC) Devices
August 2019 -
Idaho
Idaho Medicaid Provider Handbook: Physician and Non-Physician Practitioner *see page 8
January 1, 2020 -
Indiana
Long-Acting Reversible Contraception (LARC) Resource Guide: https://www.in.gov/health/laboroflove/files/Final-LARC-Guidance.pdf
March 2021 -
Kansas
Provider Bulletin – Long‐Acting Reversible Contraceptives (LARCs) and Local Health Departments (LHDs): https://www.kdhe.ks.gov/DocumentCenter/View/2762/Provider-Bulletin-PDF
KMAP General Bulletin: Reminder LARC Recommendations
May 2018 -
Louisiana
Louisiana Department of Health and Hospitals: Informational Bulletin 16-11 – Billing and Ordering Guidance for Long Acting Reversible Contraceptives (LARCs): Intrauterine Devices (IUD) and Implants
July 20, 2018Louisiana Department of Health and Hospitals: Health Plan Advisory 14-9 - Long-Acting Reversible Contraceptives (LARCs) for Inpatient Hospitals
Revised May 2016Louisiana Bureau of Health Services Financing: Hospital Services Provider Manual *See document section 25.2 page 10
July 2011 -
Maine
MaineCare Services: Adopted Rule: Chapters II & III, Section 45, Hospital Services
November 9, 2017 -
Massachusetts
All Acute Inpatient Hospitals – Billing Instructions for LARC Devices
March 1, 2018Massachusetts 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 -
Missouri
MO HealthNet Provider Bulletin Volume 41 Number 43: Long-Acting Reversible Contraceptive (LARC)
February 20, 2019MO 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: LARC Immediately After Delivery
May 1, 2018 -
Nevada
Nevada Department of Health and Human Services: Medicaid Coverage of Long-Acting Reversible Contraception Methods (LARCs)
January 2020Nevada 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 Program Manual: Medicaid Billing for LARC Products Provided in an Inpatient Setting
August 13, 2019 -
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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North Carolina
North Carolina Division of Medical Assistance: Medical Special Bulletin – Clarification on Billing for Long Acting Reversible Contraceptives
January 24, 2019North Carolina Division of Medical Assistance: Medical Special Bulletin – Update to Reimbursement of Long Acting Reversible Contraceptives (LARCs)
October 5, 2018North Carolina Division of Medical Assistance: Medical Special Bulletin – Reimbursement of Long Acting Reversible Contraceptives (LARCs)
August 2016 -
Ohio
Ohio Department of Medicaid: Office of Policy Hospital Billing Guidelines (page 36)
July 21, 2021 -
Oklahoma
Oklahoma HealthCare Authority: SoonerCare Provider Reimbursement Notice Hospital Updates – LARC
September 28, 2015 -
Oregon
Oregon Health Authority: Fee-for-Service (FFS) Billing for Postpartum Long-Acting Reversible Contraception (LARC) Services
March 3, 2017Oregon Health Authority: Health Evidence Review Commission (HERC) Coverage Guidance – Timing of Long-Acting Reversible Contraceptive (LARC) Placement
November 10, 2016Oregon Health Authority: Health Evidence Review Commission (HERC) Letter to Medical Directors – LARC Implementation
November 10, 2016 -
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 -
Rhode Island
Rhode Island Executive Office of Health and Human Services: Medicaid Fee Schedules
February 2020 -
South Carolina
South Carolina HHS: Medicaid Bulletin – Long Acting Birth Control Device Provided in a Hospital Setting
January 29, 2012South Carolina HHS: Medicaid Bulletin – (Clarification Bulletin) Long Acting Reversible Contraceptives Provided in an Inpatient Hospital Setting
August 13, 2013 -
South Dakota
South Dakota Medicaid Billing and Policy Manual: Family Planning
October 2021 -
Texas
Texas Health and Human Services: The Texas Long-Acting Reversible Contraception Toolkit (Volume 2)
June 2018 -
Utah
Utah Department of Health – Medicaid: Medicaid Information Bulletin *See page 10
January 1, 2017 -
Virginia
Virginia Department of Medical Assistance Services: Virginia Postpartum LARC Toolkit
January 2017 -
Washington
Washington State Health Care Authority: Family Planning Provider Guide - Immediate Postpartum LARC Insertion *See page 74
April 1, 2016
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Wisconsin
Wisconsin Department of Health: ForwardHealth Encounter Based Payment Guide
April 10, 2020