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Separate Reimbursement for Long-Acting Reversible Contraceptives in the FQHC Setting pdf

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Provider Bulletin
Effective date
May 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut FQHCs can now bill separately for Long-Acting Reversible Contraceptive (LARC) devices at 340B rates when inserted during medical visits. The device must be billed on the same day as insertion with specific procedure codes, while the insertion procedure remains part of the all-inclusive FQHC encounter rate.

Action Required

Action needed
Immediately: FQHC billing teams must update billing procedures to include all three required codes on CMS-1500 forms for LARC services: T1015 (clinic visit), appropriate LARC device code (J7296-J7307), and insertion procedure code (11981, 11983, or 58300). Update billing system to ensure all three codes are billed together on same date of service. Failure to include all required codes will result in only receiving the standard FQHC encounter rate instead of separate device reimbursement.

Affected Billing Codes

T1015
J7296
J7297
J7298
J7300
J7301
J7307
11981
11983
58300
Separate Reimbursement for Long-Acting Reversible Contraceptives in the FQHC Setting pdf | Connecticut Medicaid (HUSKY Health) | PolicyChanges.app