Apple Health (Medicaid): Provider Alert
Effective for dates of service on and after July 1, 2017,
use modifier FP with procedure codes 11981, 11982, and 11983 when billing for
contraceptive subdermal implant procedures.
This modifier is used by the Health Care Authority to
distinguish contraceptive drug delivery systems from other drug delivery
systems.
Providers are eligible to receive the enhanced
reimbursement rate authorized in WAC
182-531-2020 when using procedure code 11981 or 11983 to bill for the
insertion of a contraceptive drug delivery system. Providers must use the FP
modifier to receive this enhanced rate.
Noncontraceptive drug delivery systems do not qualify the
provider for the enhanced rate and the modifier FP should not be used.
Use of the FP modifier for these procedures codes is described
in the July 1 publication of the Family
Planning Billing Guide.
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