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Update to Clinic Dispensing Limits for Self-Administered Hormonal Contraceptives

July 17, 2018

Effective for dates of service on or after August 1, 2018, in accordance with Senate Bill 999, the clinic dispensing limits for self-administered hormonal contraceptives is updated for the Medi-Cal and Family Planning Access, Care and Treatment (Family PACT) programs as follows:

  • J7303 (contraceptive supply, hormone containing vaginal ring, each), is limited to a maximum dispensing quantity of up to 13 vaginal rings per client.
  • J7304 (contraceptive supply, hormone containing patch, each) is limited to a maximum dispensing quantity of up to 52 patches per client.
  • S4993 (contraceptive pills for birth control) is limited to a maximum dispensing quantity of up to 18 cycles per client.

The dispensing of up to the maximum quantity is intended for clients on continuous cycle. A 12-month supply of the same product of contraceptive vaginal rings, contraceptive patches or oral contraceptives may be dispensed twice in one year. A Treatment Authorization Request (TAR) is required for the third supply of up to 12 months of the same product requested within a year.

Updated manual pages reflecting this policy will be released in a future Family PACT Update and Medi-Cal Update.