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Provider Frequently Asked Questions
Are Family PACT Providers required to use the National Drug Code (NDC) for physician-administered drugs?
Yes. Beginning September 1, 2008, providers were encouraged to begin using National Drug Code (NDC) for physician-administered drugs, in conjunction with the customary Healthcare Common Procedure Coding System (HCPCS) Level I, II, or III code, on all Medi-Cal claims.
- Claims submitted for dates of service from September 1, 2008 through March 31, 2009, without an NDC will not be denied.
- Claims with dates of service on or after April 1, 2009, that do not meet the NDC reporting requirement to include a valid NDC paired with a HCPCS code, will result in claims being denied.
Does Family PACT reimburse for partner treatment of Chlamydia?
The Family PACT Program reimburses for treatment of Chlamydia only if the partner is enrolled in the Family PACT Program.
Is there a specific training that staff members need to complete in order to conduct Family PACT education and counseling visits?
Family PACT providers must ensure that non-clinician counselors have been trained in all family planning methods; are knowledgeable about the Family PACT Standards and program benefits; and have the essential core competence to deliver education and counseling services, including individual client history and assessment of health education and counseling needs. Within the personnel files of non-clinician counselors, providers must maintain documentation of education and counseling training and performance. For more information about counseling by non-clinician counselors see the Office Visits Section of the Family PACT Policies, Procedures and Billing Instructions (PPBI), located on-line at www.familypact.org.
Can placement of Essure® micro-inserts be performed in an outpatient setting?
Placement of the Essure® micro-inserts does not require general anesthesia and is designed to be performed in a physician’s office. However, as clinically indicated, it may be performed in an ambulatory surgery center or hospital outpatient surgery center.
What kind of record keeping does Family PACT require for Essure®?
Providers must maintain a written log or electronic record of all Essure® micro-inserts placed, including the client’s name, medical record and Family PACT client’s Health Access Program (HAP) card number, date of surgery, and lot number of the product, for at least five years from the date of insertion.
Where can a provider get training on Nexplanon® insertion?
To ensure that health care providers receive instructions and training on insertion and removal, Merck has developed the Clinical Training Program for NEXPLANON®. Only those clinicians who have completed the training program are eligible to purchase the product. You can find information about the trainings on the following website:
What kind of record keeping does Family PACT require for IUC devices and Nexplanon®
In accordance with Family PACT policy, providers should keep a written log or electronic record of all Intrauterine Contraceptive (IUC) devices and contraceptive implants inserted for at least three years from the date of insertion. Records should include the following: (1) Client’s name; (2) medical record and Health Access Program (HAP) card number; (3) date of insertion; (4) type of IUC or implant; and (5) lot number of the device or product.
What HIV tests are covered by Family PACT?
Rapid and conventional FDA-approved HIV diagnostic tests for HIV-1, HIV-2, and HIV-1&2 are covered for Family PACT clients. However, prevalence of HIV-2 in the U.S. is extremely low, and the CDC does not recommend routine HIV-2 testing in the U.S. Therefore, the clinician should order a test for HIV-1 only, unless the client is from West Africa (where HIV-2 is endemic) or has sex partners from endemic areas, has sex partners known to be infected with HIV-2, or has received a blood transfusion or non-sterile injection in a West African country.
Does Family PACT require providers to offer rapid HIV testing?
Family PACT recommends that clinics make rapid testing available (in addition to conventional testing) if a significant percentage of clients are not likely to return for results or a high HIV prevalence is known to exist at the site.
Can Family PACT services be provided off-site, such as HIV testing at an outreach event?
No. Family PACT services are required to be provided at a clinic site.
Can Family PACT client eligibility be determined off-site?
No. Client eligibility determination and completion of the Client Eligibility Certification (CEC) Form must be completed at the time of the clinic visit.
Who is served by the Office of Family Planning?
OFP is responsible for the provision of comprehensive clinical family planning services as well as health education programs to low income women and men throughout California. Clinical family planning services are provided through the Family PACT Program. Community based educational services for all persons regarding pregnancy prevention are provided through the Information and Education Program (I&E).