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Clinic Dispensing Limits Increased for Contraceptive Vaginal Ring and Patch

March 20, 2017

Effective for dates of service on or after January 1, 2017, in accordance with Senate Bill 999, the clinic dispensing policy for HCPCS codes J7303 (contraceptive supply, hormone containing vaginal ring, each) and J7304 (contraceptive supply, hormone containing patch, each) has been updated for the Medi-Cal and Family Planning Access, Care and Treatment (Family PACT) Programs as follows:

  • J7303 is limited to a maximum dispensing quantity of 12 vaginal rings per recipient in a 12-month period.
  • J7304 is limited to a maximum dispensing quantity of 36 patches per recipient in a 12-month period.

A Treatment Authorization Request (TAR) is required for an additional supply of vaginal rings or transdermal patches if they are requested within a three-month period of receiving a 12-month supply.

Though the clinic dispensing policy for J7303 and J7304 is effective January 1, 2017, providers should not bill with the updated quantity before May 1, 2017, or claims will be denied. Timeliness requirements will be overridden until notified.