​In support of our commitment to women's health equity, we want to clarify our reimbursement position concerning Long-Acting Reversible Contraceptive (LARC) devices supplied during an obstetrical delivery hospital admission.

LARCs are highly effective methods of birth control that last between 3 and 10 years (depending on the method) without requiring daily, weekly, or monthly user effort. They can reduce unintended pregnancies to improve health outcomes. Three types of LARCs are available: Hormonal and non-hormonal IUDs and implants.

Advantage of postpartum insertion

There are significant advantages to providing LARC devices while the patient is hospitalized during an obstetrical delivery. Women are at risk of an unintended pregnancy in the period immediately after delivery as resumption of ovulation may occur shortly after delivery.

Research shows that effective contraception helps prevent poor birth spacing, thereby reducing the risk of low-weight and/or premature birth. It can also be essential to a woman's long-term physical and emotional well-being.

Provider reimbursement

AmeriHealth New Jersey and AmeriHealth Pennsylvania will reimburse LARC devices administered in an inpatient setting for an obstetrical delivery, when billed on an 837P electronic or a CMS-1500 paper claim submission.

The relevant codes are:

Plan and specific group restrictions may apply. Providers should confirm individual member benefits using the Eligibility & Benefits transaction in PEAR Practice Management on the Provider Engagement, Analytics & Reporting (PEAR) portal before providing the service.