Long-Acting Reversible Contraception While Inpatient Postpartum
Defines Humana Kentucky Medicaid facility payment policy for separate reimbursement of LARC devices inserted for postpartum inpatients and instructs billing submission requirements for facilities.
No material clinical or coverage changes in this revision.
Inpatient Postpartum Facility Payment Criteria
Inpatient postpartum facility payment criteria
Facility reimbursement conditions for inpatient postpartum LARC insertion:
ALL of the following
- Applies only to facility services for postpartum inpatients.
- Insertion of a LARC device is reimbursed separately from the inpatient hospital labor and delivery DRG at the fee schedule rate.
- Facility must submit a UB-04 claim (or electronic equivalent) using type of bill (TOB) 11X to facilitate separate payment.
- Facility should report the insertion with one of the HCPCS codes J7296, J7297, J7298, J7300, J7301, or J7307.
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