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Transmittal 19-20-Enrollment & Code and Rate for Lactation Consultation Services

Thursday, September 26, 2019

Transmittal 19-20- The purpose of this transmittal is to announce that board certified lactation consultants (non-physician; certified mid wife or registered lactation consultant) can now enroll as a provider with the District of Columbia (DC) Medicaid program and bill for lactation consultation services as covered under ‘pregnancy-related services' under the District's State Medicaid Plan. Lactation consultation services offered by lactation consultants shall be billed under HCPCS code S9443 and reimbursed at a rate of $15.63 per unit (1 unit = 15 minutes) with a maximum of four units per visit and a total of four (4) visits or 16 units for 120 days after delivery effective January 1, 2019.