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Post Partum LARC

Post-Partum Long Acting Reversible Contraception (LARC)

Working as a coalition of members from the medical community, local non-profits and interested community members, this page provides information and resources for providers and hospitals on the topic of post-partum long-acting reversible contraception (LARC).

Billing and Reimbursement Resources
Clinical Resources and Guidance

ACOG (American College of Obstetricians and Gynecologists)

  • Post-partum Contraceptive Access Initiative provides an online resource hub on topics such as clinical best practices, contraceptive counseling, and implementation of IPP LARC. All resources are free, open access, and downloadable.
  • LARC Help Desk is a free technical assistance service that is open to both ACOG Fellows and non-members.
  • COVID-19 FAQs provide clinical guidance around COVID-19 for providers, including around providing and optimizing contraception and post-partum LARC.

AWHONN (Association of Women’s Health, Obstetric and Neonatal Nurses)

  • LARC Resources page includes peer-reviewed journal articles, guidance, and video tools.

ASTHO (Association of State and Territorial Health Officials)

NIRH (National Institute for Reproductive Health)

  • LARC Toolkits– This page includes toolkits created with NIRH’s LARC Access Project partners that provides general guidance on LARC, including creating effective referral pathways for LARC providers.
Immediate Post-partum LARC State Toolkits

Various organizations, collaboratives, and governments have created state-specific post-partum LARC toolkits and resources. Below please find some examples of state toolkits and resources:

Guidance on creating a toolkit:

Please connect with us via email at info@arizonafamilyhealth.org if you have questions or additional resources to share.

Arizona FAQ’s Download PDF

Will my hospital get paid for post-partum LARC when the procedure does not change my hospital's DRG reimbursement?
In many cases, yes. Effective October 1, 2016, AHCCCS reimbursement policy allows LARC devices to be billed and reimbursed outside the AHCCCS DRG payment. This means the hospital will receive its regular DRG payment plus an additional reimbursement for inpatient LARC. Some commercial payers also pay separately for inpatient post-partum LARC. Please check with your finance department.
How can I bill AHCCCS for inpatient LARC? I have heard that I can only bill on the 1500, which is not part of my normal inpatient billing process.
According to AHCCCS DRG Payment Policies, as of October 1, 2016, hospitals may bill for LARC separately, outside the DRG billing, on a professional form 1500. In addition, because many hospitals had trouble billing inpatient services on the 1500, AHCCCS allowed hospitals to bill inpatient LARC on a separate outpatient form UB 04 beginning October 1, 2017.

Whether billing on the 1500 or the UB, AHCCCS has identified the following HCPCS codes as eligible for separate reimbursement. Claims submitted must include one of the following codes:

  • J7296 – Levonorgestrel-Releasing Intrauterine Contraceptive System, 19.5mg
  • J7297 Levonorgestrel-Releasing Intrauterine Contraceptive System, 52mg, 3 Year Duration
  • J7298 Levonorgestrel-Releasing Intrauterine Contraceptive System, 52 Mg, 5 Year Duration
  • J7300 Intrauterine Copper Contraceptive
  • J7301 Levonorgestrel-Releasing Intrauterine Contraceptive System, 13.5 Mg
  • J7307 Etonogestrel (Contraceptive) Implant System, Including Implant And Supplies
What are the standard AHCCCS hospital rates for LARC?
AHCCCS rates for LARC can be found on the Outpatient Fee-Schedule, which is updated annually. While AHCCCS health plans (managed care organizations) are not required to match the AHCCCS fee schedule, most base their reimbursement on some percentage of the AHCCCS fee schedule. Your hospital’s contract will specify their health plan rates.
AHCCCS reimbursement is never sufficient to cover my costs. When will they increase rates?
AHCCCS recently established a 10% rate increase for hospital reimbursement (both inpatient and outpatient) for LARC for claims dates of service between October 1, 2019 through September 30, 2020. For hospitals subject to APR-DRG reimbursement (AHCCCS Provider Type 02), AHCCCS has increased both its fee-for-service and managed care rates for the following codes (billed on the 1500 or UB-04):

  • J7296 – Levonorgestrel-Releasing Intrauterine Contraceptive System, 19.5mg
  • J7297 Levonorgestrel-Releasing Intrauterine Contraceptive System, 52mg, 3 Year Duration
  • J7298 Levonorgestrel-Releasing Intrauterine Contraceptive System, 52 Mg, 5 Year Duration
  • J7300 Intrauterine Copper Contraceptive
  • J7301 Levonorgestrel-Releasing Intrauterine Contraceptive System, 13.5 Mg
  • J7307 Etonogestrel (Contraceptive) Implant System, Including Implant And Supplies
How do other insurance companies cover LARC?
Coverage varies by insurance company, but some insurers do pay separately for inpatient post-partum LARC. Your hospital’s individual contracts with payers will detail the method of reimbursement.
What are some things I should consider if I want to start performing post-partum LARC? Are there resources available to help me?
The Arizona Family Health Partnership provides resources for clinicians who are interested in learning more about post-partum LARC and opportunities to provide it within their practice. AFHP can also facilitate connections with clinicians who have experience in post-partum LARC.

Please contact AFHP at bthomas@arizonafamilyhealth.org or at 602.258.5777 if you have any questions.

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