MedicaidAdministrativeMedium impact
Long-Acting Reversible Contraception (LARC) Devices for Dual Eligible Participants
Missouri Medicaid (MO HealthNet)·MO · OB-GYN, Family Medicine, Internal Medicine·Provider Notice
Effective date
Jul 14, 2022
We identified it
Jun 20, 2026
Summary
Missouri Medicaid (MO HealthNet) will reimburse providers for LARC devices for dual eligible participants even when Medicare doesn't cover them. Providers must check eligibility criteria first, then submit a claim to Medicaid and contact the Pharmacy Administration Unit for an override to bypass fiscal edits that prevent duplicate billing.
Action Required
For dual eligible patients needing LARC devices: 1) Check eligibility criteria at http://dss.mo.gov/mhd/cs/pharmacy/pdf/non-oral-contraceptives.pdf before billing, 2) Submit claim to MO HealthNet, 3) Contact Pharmacy Administration Unit at 573-751-6963 or MHD.PharmacyAdmin@dss.mo.gov to obtain override for fiscal edit approval. Document all steps to ensure reimbursement.