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Long-acting reversible contraception
Act
immediately
Effective date
Not stated in the notice
Identified
Jul 29, 2026
Summary
Geisinger Health Plan (GHP) now reimburses hospitals separately for long-acting reversible contraception (LARC) devices—intrauterine devices and contraceptive implants—provided immediately postpartum to GHP Family Medicaid patients, in addition to the standard APR-DRG obstetrical delivery payment. Billing teams must submit LARC claims using outpatient hospital claim format with appropriate procedure codes and modifiers from the Medicaid fee schedule.
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What to do
immediately · 4 steps
01Billing team must identify and implement LARC procedure codes (from Medicaid fee schedule) for intrauterine devices and contraceptive implants used in immediate postpartum settings.
02Update billing software to recognize LARC as a separately reimbursable service for GHP Family Medicaid obstetrical claims.
03Providers and clinical staff should be notified that LARC devices provided postpartum are now covered separately and should be documented and billed on outpatient hospital claims in addition to delivery claims.
04Verify that claim submission includes appropriate procedure codes and modifiers per Medicaid fee schedule.
If missed: Failure to properly code and submit LARC claims may result in missed reimbursement opportunities.
Original notice
Long-acting reversible contraception
geisinger.org · Always check the source before changing claims.