Ala. Admin. Code r. 560-X-14-.03

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-14-.03 - Family Planning Services

(1) The following services are covered services when provided by Family Planning providers. Details on criteria required for each type of service is listed in the Family Planning Program Manual.

(a) Initial Visit - an in-depth evaluation of a new patient requiring the establishment of medical records, evaluation of the data obtained, comprehensive history, complete physical examination, appropriate diagnostic lab tests and/or procedures, family planning counseling, and contraceptive management as indicated. Limited to one per provider.

(b) Annual Visit - the reevaluation of an established patient requiring an update to medical records, evaluation of the new data obtained, interim history, complete physical examination, appropriate diagnostic laboratory tests and/or procedures, family planning counseling, and adjustment of contraceptive management as indicated.

(c) Periodic Revisit - a follow-up evaluation of a new or existing family planning condition. Services include a review with update of history, a review of the effectiveness of current contraceptive method with counseling regarding any existing problems and adjustment of contraceptive method to include issuance of supplies as indicated. This visit includes scheduled follow-up, as medically indicated, of chosen birth control method. Limited to no more than four (4) revisits per calendar year.

(d) Home Visit - a brief evaluation by a medical professional in the home of established patients. Services provided include an abbreviated history, weight and blood pressure, and contraceptive counseling with issuance of contraceptive supplies if indicated. A follow-up clinic appointment is scheduled if indicated. Limited to one visit during the 60-day post partum period.

(e) Extended Family Planning Counseling Visit - a separate and distinct counseling service provided at the time of the post partum visit requiring a minimum of 10 minutes of face-to-face contact. Limited to one service during the post examination.

(f) Routine laboratory screening tests such as pregnancy testing, VDRL, gonorrhea culture, Pap smear, hemoglobin or hematocrit and urine check are covered when performed as a part of the initial/annual family planning service.

(2) The following procedures are covered under Family Planning if provided for contraceptive purposes:

(a) Insertion or removal of implantable contraceptive capsules when performed by or under the supervision of a physician.

(b) Insertion or removal of intrauterine devices when performed by or under the supervision of a physician.

(c) Fitting of a diaphragm when performed by or under the supervision of a physician.

(3) Medically approved pharmaceutical supplies and devices such as oral contraceptive pills, foams, jellies, creams, diaphragms, intrauterine devices, injections and implants are covered if provided for family planning purposes.

Authors: Gail H. Ellerbrake, Deborah K. Crawford, Dee Lockridge

Ala. Admin. Code r. 560-X-14-.03

Rule effective October 1, 1982. Amended effective February 9, 1987; December 10, 1987; June 12, 1991; August 12, 1992. Amended: Filed August 6, 1993; effective September 10, 1993. Amended: Filed July 6, 1995; effective August 12, 1995.

Statutory Authority: State Plan; 42 C.F.R. §441.20; Title XIX, Social Security Act.