Section 30, Family Planning, Implementation of Base Rate and Resulting Final Rate, CR 122825

Feb 16, 2024

Effective January 1, 2024, the Department has updated the base rates and resulting final rates for certain Family Planning Services delivered by eligible providers. These new rates were implemented for billing on February 15, 2024.

Only providers engaged primarily in the delivery of sexual and reproductive health care services, as described in 42 United States Code, Section 1396d(a)(4)(c) are eligible to bill add-on rates. 

You may view the full fee schedule, including the base rates, add-on rates, and final rates, on the Health PAS Online Portal.

Adjustment of Claims

• For claims submitted with charges at or above, the new rates, the Department will reprocess dates of service January 1, 2024, through February 14, 2024, and no provider action is needed. 
• For claims submitted with charges below the new rates for the same date span above, Providers will need to adjust claims within 120 days of the original payment date. Please work the oldest dates first.

For questions, please contact your Provider Relations Specialist.