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December 2016 Texas Medicaid Provider Procedures Manual

Women’s Health Services Handbook : 3 Health and Human Services Commission (HHSC) Family Planning Program Services : 3.2 Services, Benefits, Limitations, and Prior Authorization : 3.2.6 Contraceptive Devices and Related Procedures

3.2.6
3.2.6.1
The following procedure codes may be reimbursed separately from the fitting and instruction (procedure code 57170):
 

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