MedicaidReimbursementMedium impact
Long-acting reversible contraceptive alternative payment methodology
Geisinger Health Plan·PA · OB-GYN, Family Medicine, General Practice·Claims
We identified it
Jul 29, 2026
Summary
Geisinger Health Plan now provides supplemental payment under the Pennsylvania Department of Human Services Medical Assistance (MA) alternative payment methodology (APM) for long-acting reversible contraceptive (LARC) device insertion and removal at federally qualified health centers (FQHCs) and rural health clinics (RHCs). This supplemental payment offsets high device costs and allows same-visit insertion/removal for MA beneficiaries.
Action Required
Immediately: Billing team must determine if your practice qualifies as an FQHC or RHC eligible for the LARC APM. If eligible, contact Geisinger Health Plan to opt-in to this supplemental payment program and obtain specific billing instructions. Reference the official MA Bulletin for exact billing codes, modifiers, and submission requirements for LARC insertion and removal procedures. Update billing software and encounter workflows once opt-in is complete. Failure to opt-in may result in missed supplemental payment opportunities for MA beneficiaries.