Providers can prescribe and obtain LARC products on the Medicaid and Healthy Texas Women (HTW) Program formularies from certain specialty pharmacies for women participating in those programs. LARC products are only available through these specialty pharmacies working with LARC manufacturers. Providers who prescribe and obtain LARC products through these specialty pharmacies will be able to return unused and unopened LARC products to the manufacturer's third-party processor. Providers may continue to obtain products through the existing buy-and-bill process.
Refer to the Refer to the Texas Medicaid Provider Procedures Manual Outpatient Drug Services Handbook for detailed information regarding prescribing and obtaining LARC products and the LARC buy-back program.
LARC Drugs
| Drug Name | Generic Name | NDC | Programs |
|---|---|---|---|
| KYLEENA 19.5 MG SYSTEM | levonorgestrel | 50419042401 | Medicaid, HTW |
| MIRENA 52 MG SYSTEM | levonorgestrel | 50419042301 | Medicaid, HTW |
| NEXPLANON 68 MG IMPLANT | etonogestrel | 00052433001 | Medicaid, HTW |
| PARAGARD T 380-A IUD | copper | 59365512801 | Medicaid, HTW |
| SKYLA 13.5 MG SYSTEM | levonorgestrel | 50419042201 | Medicaid, HTW |
Manufacturer Resources
Bayer
Merck
Cooper Surgical