Date: July 13, 2020
To: Enrolled Hospitals: Chief Executive Officers; Chief Financial Officers; and Patient Accounts Managers
Re: Inpatient Claims Containing LARC Device Codes
This notice provides interim guidance to hospitals for inpatient claims containing long-acting reversible contraceptive (LARC) HCPCS codes. The claim instructions below apply only to participants covered under traditional Medicaid fee-for-service.
By provider notice dated June 24, 2020, hospitals were instructed that for inpatient discharges beginning July 1, 2020, the LARC device charge should be included on the hospital inpatient claim, and it will price as an add-on amount to the APR-DRG payment determined for the inpatient delivery. Until system changes are completed, hospitals are instructed to hold fee-for-service claims that contain a LARC HCPCS code. Hospitals will be notified when the system changes are completed, so that the claims may be submitted and paid correctly.
Interim Medicaid Administrator