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2024.83 - Provider Bulletin - Changes for Billing Long-Acting Reversible Contraceptive Devices in the Medical FQHC Setting

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Starting January 1, 2025, all 340B covered FQHCs must replace modifier JG with modifier TB when billing for Long-Acting Reversible Contraceptive (LARC) devices. Claims using the old JG modifier after December 31, 2024 will be denied.

Action Required

Action needed
Before January 1, 2025: Billing team must update billing system to use modifier TB instead of modifier JG for all LARC device codes (J7296, J7297, J7298, J7300, J7301, J7307) for 340B covered entities. Update encounter forms and billing software rules to prevent use of JG modifier. Failure to switch modifiers will result in claim denials with EOB codes 0251-0253 and 4545.

Affected Billing Codes

T1015
J7296
J7297
J7298
J7300
J7301
J7307
11981
11983
58300