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MedicaidCoverageMedium impact

Coverage for Kyleena – Intrauterine Device (IUD)

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Nov 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY programs) now covers Kyleena IUD effective November 1, 2016. Different billing codes and reimbursement rates apply by provider type: hospitals use C9399 ($858.33), physicians/APRNs/CNMs/PAs use J3490 ($858.33), and family planning clinics use S5001 ($235.00).

Action Required

Action needed
Immediately: Connecticut providers billing for Kyleena IUD must use specific temporary codes until unique HCPCS assigned. Hospitals use C9399, physicians/APRNs/CNMs/PAs use J3490, family planning clinics use S5001. ALL claims must include the NDC number for Kyleena or claims will be denied. Update billing software with correct codes and rates by provider type.

Affected Billing Codes

C9399
J3490
S5001