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016.06.20-216.513. Contraception

AR ADC 016.06.20-216.513Arkansas Administrative CodeEffective: December 1, 2021

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 20. Hospital/Critical Access Hospital (CAH)/End-Stage Renal Disease (ESRD) Provider Manual (Refs & Annos)
Section 210.000. Program Coverage -- Hospital and Critical Access Hospital.
Effective: December 1, 2021
Ark. Admin. Code 016.06.20-216.513
016.06.20-216.513. Contraception
A. Prescription and Non-Prescription Contraceptives
1. Medicaid covers birth control pills and other prescription contraceptives as a family planning prescription benefit.
2. Medicaid covers non-prescription contraceptives as a family planning benefit when a physician writes a prescription for them.
B. Contraceptive Implant Systems
1. Medicaid covers the contraceptive implant systems, including implants and supplies. However, the Arkansas Medicaid family planning Aid Category 69 (FP-W) does not cover this device. However, Medicaid covers the removal of this device.
2. Medicaid covers insertion, removal and removal with reinsertion.
C. Intrauterine Device (IUD)
1. Medicaid pays for IUDs as a family planning benefit.
2. Alternatively, Medicaid reimburses hospitals that supply the IUD at the time of insertion.
3. Medicaid pays hospitals for IUD insertion and removal.
4. Outpatient Global Surgery rules apply. See Section 272.160.
D. Medroxyprogesterone Acetate
Medicaid covers medroxyprogesterone acetate injections for birth control.
E. Sterilization
1. All adult (21 or older) male or female Medicaid beneficiaries who are mentally competent are eligible for sterilization procedures as long as they remain Medicaid-eligible.
2. Medicaid covers Occlusion by Placement of Permanent Implants. Coverage includes the procedure, the implant device and follow-up procedures as specified in Section 216.515.
3. Refer to Section 216.514 of this manual for Medicaid policy regarding sterilization.
4. Refer to Sections 216.100, 216.130-216.132, 216.510-216.515, and 216.540-216.550 of this manual for family planning procedure codes and billing instructions for family planning services.

Credits

Adopted Dec. 1, 2021.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.20-216.513, AR ADC 016.06.20-216.513
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