Provider Alert! Health and Human Services (HHS) Promotes Women’s Health by Raising Awareness of Long-Acting Reversible Contraception (LARC)
Effective Date: March 5, 2020
The American College of Obstetricians and Gynecologists recommends LARCs for the following reasons:
- LARCs are the most effective reversible contraceptive method
- There is no further action required for the patient to avoid pregnancy after the device is in place
- LARCs have high rates of patient satisfaction and method continuation
- LARCs can be removed at any time if the patient plans to conceive or use another form of birth control
How this impacts providers: Providers must decide if their patient qualifies as an ideal candidate for LARC by following the recommendations outlined in the HHS Texas LARC Toolkit: Texas LARC Toolkit
When providers recommend a LARC for their patient they should ensure proper education and understanding prior to obtaining consent from the patient.
Next steps for providers: Providers should verify that correct billing processes are in place including proper coding. For LARCs, the provider will bill for both insertion of the device and the device itself. The date of the insertion and the date of the device claim do not have to be the same for reimbursement.
LARC Codes
| Code | Description |
| 58300 | IUD Insertion |
| 11981 | Implant Insertion |
LARC Device codes
| Code | Description |
| J7297 | Liletta® |
| J7298 | Mirena ® |
| J7300 | Paragard® |
| J7301 | Skyla® |
| J7307 | Nexplanon® |
| J7296 | Kyleena ® |
LARC resources for providers:
Texas Medicaid Provider Procedures Manual LARC Policy
Texas Vendor Drug Program LARC Products
Texas Health Steps LARC Course
The American College of Obstetricians and Gynecologists LARC clinical and training resources
LARCs are a covered service in both the Healthy Texas Women program and the Family Planning Program and for Medicaid members who receive care through Medicaid for Pregnant Women. This service is excluded from the CHIP Program.
If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers
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