What insurance policy changes affect CPT 58300?

There are 9 tracked policy changes affecting CPT 58300, including updates from Nevada Medicaid, Arkansas Medicaid, Pennsylvania Medicaid (DHS). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 58300?

Payers that have issued tracked updates for CPT 58300 include: Nevada Medicaid, Arkansas Medicaid, Pennsylvania Medicaid (DHS), Medical Mutual of Ohio, Blue Cross Blue Shield of Rhode Island, Arizona Medicaid - AHCCCS.

How do I get notified when CPT 58300 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 58300. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 58300?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

58300 — A doctor places a small contraceptive device inside the uterus to prevent pregnancy.: Insurance Policy Changes

58300 Insurance Policy Changes

CPT 58300, in plain terms, covers A doctor places a small contraceptive device inside the uterus to prevent pregnancy. CPT 58300 is referenced in 9 tracked payer policy changes from Nevada Medicaid, Arkansas Medicaid, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 58300 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Attention Provider Type 17 (Special Clinics) Specialties 180 (Rural Health Clinics), 181 (Federally Qualified Health Centers), and 182 (Indian Health Services, Urban Indian Organizations): Long-Acting Reversible Contraception (LARC) Updates

Nevada Medicaid·Effective Mar 18, 2025

Nevada Medicaid now requires modifier 25 when billing medical encounters (G0466, G0467, G0468) with Long-Acting Reversible Contraception (LARC) services for special clinics. Providers must also bill their usual and customary amounts for LARC services, as claims billed at $0.00 will be paid $0.00.

58300 Insurance Policy Changes

Attention Provider Type 17 (Special Clinics) Specialties 180 (Rural Health Clinics), 181 (Federally Qualified Health Centers), and 182 (Indian Health Services, Urban Indian Organizations): Long-Acting Reversible Contraception (LARC) Updates

Coverage for Procedure Codes 58300 and 58301

MAB2025123003

MAB2025040301

Attention Provider Types 11 (Hospital, Inpatient) and 75 (Critical Access Hospital): Long-Acting Reversible Contraception Devices Services Now Open For Billing

Attention Provider Types 11 (Hospital, Inpatient) and 75 (Critical Access Hospital): Long-Acting Reversible Contraception Devices Services Will Be Opened for Billing

Proper Documentation and Coding to Accurately Capture HEDIS PPC Measure

Hints for HEDIS

AHCCCS DFSM Claims Clues - July/August 2020