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20.7.6.1 Dispensing Medication
Family planning providers have a choice of dispensing family planning drugs and supplies directly to the client and billing TMHP or giving clients prescriptions to take to a pharmacy. Family planning drugs and supplies that are dispensed directly to the client are billed to TMHP or a Medicaid managed care organization (MCO), whichever is appropriate for the client. Providers who also contract with DSHS for Title V, X, or XX should refer to the DSHS Title V, X, and XX Family Planning Policy Manual for additional guidance on dispensing medication to Title V, X, or XX clients.
Procedure code J3490 may be billed when a prescription medication to treat a genital infection is provided to the client. Procedure code A9150 with modifier FP may be billed when a nonprescription medication to treat a monilia infection is provided to the client. Family planning drugs and supplies are exempt from the three prescriptions-per-month rule. Additionally, pharmacies under the Vendor Drug Program contract are allowed to fill the prescription for up to six months at a time, rather than a one-month supply.
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