Improve maternal health outcomes through immediate postpartum LARC insertion

Immediate postpartum Long Acting Reversible Contraception (LARC) insertion refers to the insertion of an intrauterine device (IUD) in the delivery room immediately after delivery of the placenta, or insertion of an IUD or subdermal contraceptive implant prior to hospital discharge. LARCs are beneficial to subsequent maternal health outcomes as they enhance family planning and safer birth spacing.

The postpartum period is a convenient opportunity to initiate LARCs, especially given the engagement of women with health care services during this time. In addition, it is a time to optimize reimbursement as the women retain their Medicaid coverage at delivery. In January 2016, Texas Medicaid revised its reimbursement policies to enable hospitals and providers to receive full reimbursement (outside the global fee for delivery) for the LARC device and the provider insertion procedure fee when women receive a LARC postpartum, prior to being discharged from the hospital.

LARC devices are a benefit when administered in a hospital setting in addition to the diagnosis related group payment when a LARC device is inserted immediately postpartum. When a LARC device is inserted immediately postpartum, facilities will be paid an outlier payment for the following codes: J7300, J7301, J7307. Hospitals who obtain the LARC device via the 340B drug program will need to use the U8 modifier on the claim line.

For more information on immediate postpartum LARC insertion, please refer to the HHSC LARC Toolkit. It can be found at https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/health/women/texas-larc-toolkit.pdf.

If you have any questions or need additional information about LARC billing, please contact Provider Relations by calling 832-828-1008 or toll-free 1-800-731-8527.