Reimbursement Rate Update for Long Acting Reversible Contraceptives (LARCs)

PROVIDER ALERT

 

The South Carolina Department of Health and Human Services (SCDHHS) has confirmed that the state tax exemption for physician administered injectable drugs (South Carolina Sales and Use Tax Act, 12-36-2120 (80)) does not apply to intrauterine devices or contraceptive implants. To ensure continued access to these products, SCDHHS has updated the reimbursement rates indicated below, effective July 1, 2016.

 

HCPCS

Name

Previous Rate

New Rate

J7300

ParaGard®

$745.00

$804.50

J7301

Skyla®

$655.52

$707.96

J7307

Nexplanon®

$777.69

$839.91

J7297

Liletta®

$630.00

$680.40

J7298

Mirena®

$816.99

$882.35

 

 

Any future changes to the reimbursement rate for these products will be communicated through the standard fee schedule update process and may not be communicated via Medicaid bulletin or alert.

 

This alert applies to services provided to beneficiaries who are enrolled in fee-for-service Medicaid. South Carolina Medicaid managed care organizations (MCOs) should be contacted directly for information on their Long Acting Reversible Contraceptives (LARCs) coverage.

 

If you have any questions regarding this alert, please contact the Provider Service Center at (888) 289-0709.

 

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

Report Fraud