Medicaid inpatient long-acting reversible contraception device reimbursement

Starting Oct. 1, 2018, the Michigan Department of Health and Human Services is changing the inpatient long-acting reversible contraception (LARC) device reimbursement policy. Specifically, MDHHS will provide reimbursement, separate from the maternity diagnosis-related group (DRG) payment, for immediate postpartum LARC device insertion in the inpatient hospital setting prior to discharge. Previously, patients had to wait 30 days after delivery to have a LARC placed.

How to claim reimbursement

For reimbursement of the LARC device, the facility must submit a separate professional claim with place of service 21 – Inpatient Hospital. The professional claim would include the hospital as the billing provider and the practitioner performing the related procedure as the rendering provider. When billing for an IUD or contraceptive implant device, the provider must use the appropriate Healthcare Common Procedure Coding System (HCPCS) Level II procedure code and National Drug Code (NDC).

Questions?

For additional information see the MDHHS bulletin