Long-acting reversible contraceptive alternative payment methodology

As part of our contractual agreement with the Pennsylvania Department of Human Services, Geisinger Health Plan follows the long-acting reversible contraceptive (LARC) alternative payment methodology (APM) established by DHS.

The APM for federally qualified health centers (FQHCs) and rural health clinics (RHCs) provides supplemental payment at the Medical Assistance (MA) fee-schedule rate for the insertion or removal of a LARC device. This supplemental payment is designed to offset the high cost of LARC devices, enabling FQHCs and RHCs to offer these services during the same visit in which an MA beneficiary expresses interest, eliminating the need for a second appointment.

For opt-in and billing information, refer to the official MA Bulletin.