The following policy updates to the 1E-7 Family Planning (FP) Services policy are being made and will be effective Jan. 1, 2023.
This policy was updated throughout to remove the requirement for a “comprehensive annual exam” and added “comprehensive annual exam or annual assessment” prior to providing family planning and family planning related services. The differences between the two exams are defined throughout policy.
New coverage includes:
- Hepatitis B and C screening
- Human Papillomavirus (HPV) (Gardasil 9) Vaccine
- United States Preventive Services Task Force (USPSTF) recommendations for chlamydia and gonorrhea testing
- IUD (intrauterine device) removal in LHD, FQHC and RHC places of service
- Removed the referral to the Department of Social Services (DSS) in the event a beneficiary doesn’t have family planning needs
- Reinforced a contraceptive primary diagnosis is required for FP claim reimbursement (Refer to Attachment A)
- The CPT tables were updated to current coverage
Providers are encouraged to review Clinical Coverage Policy 1E-7, Family Planning Services on the Program Specific Clinical Coverage webpage for a detailed overview of other general language and formatting updates to the policy.
Contact
NCTracks Call Center: 800-688-6696