Immediate postpartum long-acting reversible contraceptives (LARCs): claim processing procedure update
Long-acting reversible contraceptives (LARCs) are beneficial to subsequent maternal health outcomes as they enhance family planning and safer birth spacing. The Texas Medicaid Provider Procedures Manual was updated earlier this year to reflect new language related to immediate postpartum LARC device insertion.
Language in subsection 2.2.5.4, “Immediate Postpartum Insertion of IUDs and Implantable Contraceptive Capsules” was updated regarding immediate postpartum LARC insertion and claim processing procedures. The new language states that procedure codes for LARCs may be reimbursed in addition to the hospital diagnosis related group (DRG) payment when insertion is performed immediately postpartum.
“Immediately postpartum” refers to the following:
- Insertion within 10-15 minutes of placental delivery for intrauterine devices (IUDs)
- Insertion prior to discharge for implantable contraceptive capsules
For claims submitted to the Texas Medicaid and Healthcare Partnership (TMHP) for processing, hospital and facility providers must submit an outpatient claim with the appropriate procedure code for the contraceptive device in addition to the inpatient claim for the delivery services.
For claims submitted to Texas Children’s Health Plan, providers must follow the claim processing procedures for reimbursement of immediate postpartum LARC devices in addition to the rate for delivery services.
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