Reimbursement for Lactation Support Services

MO-11-0012 BFP

American Academy of Pediatrics (AAP)

• The AAP is encouraging the evaluation of a newborn at both day 3 and week 2, in order to provide timely and appropriate breastfeeding evaluations and interventions and prevent infant health complications as well as inappropriate early supplementation. A sample of documentation for those visits can be found under “AAP Breastfeeding Assessment (Word)”
• Supporting Breastfeeding and Lactation: The Primary Care Pediatrician’s Guide to Getting Paid (PDF) - Updated 11/2010
• Integrating Breastfeeding into Your Primary Care Practice…And getting paid! (PDF). A PowerPoint by Dr. Jenny Thomas, MD, IBCLC, FAAP, FABM from Connecticut
  

Academy of Breastfeeding Medicine (ABM)

• The ABM provides clear guidelines related to discharge and post-discharge assessment and support in its “Guidelines for Hospital Discharge of the Breastfeeding Term Newborn and Mother: ‘The Going Home Protocol (PDF)’”

United States Lactation Consultant Association

• The cost effectiveness of the use of Lactation Consultants in the primary care practice is available at: CONTAINING HEALTH CARE COSTS: HELP IN PLAIN SIGHT (PDF)
• IBCLC Staffing Recommendations - July, 2010 (PDF)

MediCal

• Breast Feeding-Related Evaluation and Management Services Billing Update
• Comprehensive Perinatal Services Program (CPSP)
• Potential opportunities to bill for Lactation Services Billing for Lactation Services in CPSP (PDF)
• Example of documentation of Breastfeeding Support Group Services in CPSP (Word)
• Ramping Up for Reform: Quality Breastfeeding Support in Preventive Care (PDF)
  information and methods for providing and coordinating breastfeeding support and billing Medi-Cal.
• Reimbursement for Durable Medical Equipment related to breastfeeding (PDF)
• Lactation Management Aids
• Breast pumps (manual, electric and hospital grade)
• Haberman Feeder