Are you a provider that is located in NY and are certified by a nationally accredited agency to provide lactation  counseling services? Then this blog post is for you!

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Which plans types have this benefit available?

• Essential Plan (EP)
  •Medicaid Managed Care (MMC)
  •Qualified Health Plan (QHP)
  •HFIC
  •Personal Wellness Plan (PWP/HARP)

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Qualified Providers:

• Physician, midwife, NP, PA, or a RN AND
• International Board-Certified Lactation Consultant (IBCLC)
  •Certified Lactation Specialist (CLS)
  •Certified Breastfeeding Specialist (CBS)
  •Certified Lactation Counselor (CLC)
  •Certified Lactation Educator (CLE)
  •Certified Clinical Lactationist (CCL)
  •Certified Breastfeeding Educator (CBE)

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Coding:

• S9445- Patient Education, not otherwise classified, non-physician provider, individual, per session.
• S9446- Patient education, not otherwise classified, non-physician provider, group, per session

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Place of service:

• 02-Teleheath
  •10-Teleheath-Remote Site
  •11- Office
  •19- Off-Campus outpatient
  •22- Outpatient Hospital

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For more billing and documentation please see Healthfirst reimbursement policy: PO-RE-111 Lactation Services

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• Healthfist: Lactation services
• MVP- Allergy reimbursement policy- updated
• Anthem BCBS NY: professional services update-facility policy
• Anthem BCBS MLTC program contact info update
• Fidelis Medicare: prior auth updates