Long-acting reversible contraception (LARC), Medicaid

Applies to:

Medicaid and Healthy Michigan Plan

Definition:

Long-acting reversible contraception (LARC) is a form of birth control that can prevent pregnancy for several years. LARC methods include intrauterine devices (IUDs) and hormonal implants.

Coverage:

For Medicaid, no prior authorization is required for family planning services. To know which LARC products are covered, refer to the applicable fee schedule. If HCPCS is listed on the fee schedule for the date of service, the product is covered.  

Billing:

Priority Health Choice, Inc. aligns with the Michigan Department of Health and Human Services (MDHHS) practices for reimbursement and claims processing rules of LARC services devices and associated administration. Providers should reference the Medicaid Provider Manual for MDHHS billing guidance.