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