Can patients seen at a lactation center have the fee covered by insurance?
Some US states have coverage for outpatients. In these states coverage may depend on the health professional background of the IBCLC. For example, the family may be able to claim for the visit if the IBCLC is also a speech pathologist or nurse practitioner. Coverage also varies from policy to policy. In Oklahoma, Medicaid coverage was recently approved for outpatient lactation consult visits with the IBCLC who is also a licensed health care provider, such as an RN. In the past twelve months, there has been a move in Australia for IBCLC’s to work in general practice and pediatric physician practices. The doctor sees the patient for a short consult; then the IBCLC takes over, and the billing is handled as a doctor visit. For more information, see ILCA’s Reimbursement Tool Kit for Lactation Consultants in the ILCA Store.
