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016.06.20-216.000. Family Planning

AR ADC 016.06.20-216.000Arkansas Administrative CodeEffective: January 1, 2024

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: January 1, 2024
Ark. Admin. Code 016.06.20-216.000
016.06.20-216.000. Family Planning
Currentness
States participating in the Medicaid Program are required to cover family planning services. Arkansas Medicaid covers family planning services in a variety of settings, including hospitals. See Sections 216.100-216.110, 216.130-216.132, 216.515 and 216.540-216.550 for Family Planning Information.
Effective 1/1/24, providers are allowed to bill for Long-Acting Reversible Contraception (LARC) devices and professional services immediately after childbirth and during post-partum, while the beneficiary remains in an inpatient setting.
Billing guidelines:
A. The Hospital should continue to bill the inpatient stay on an inpatient claim (CMS-1450, formerly UB-04).
B. If the hospital provides the LARC device, the hospital is to bill the LARC device on an outpatient claim (CMS-1450, formerly UB-04), even though the dates fall within an inpatient stay. On the outpatient claim, see LARC billing combinations for billing codes. Ensure the applicable NDC code is submitted on the claim.
C. Physician charges can be billed for insertion and removal on a professional claim (CMS-1500), in addition to their delivery charges. The physician can also charge for the LARC device, if provided by the Physician. See LARC billing combinations for billing codes.
D. The 340-B rules and modifiers to the LARC code combinations apply, when applicable.

Credits

Eff. Oct. 13, 2003. Amended Jan. 1, 2024.
<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 016.06.20-216.000, AR ADC 016.06.20-216.000
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