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I currently do outpatient visits in a family physician clinic and we are having a meeting in a week to discuss/hopefully update our coding for lactation office visits. With the new Affordable Healthcare Act requirements, we have had a few moms lately questioning why they have to pay copays. We are currently using 99211/nurse visit for both mom and baby and then my supervising physician closes all my encounters. Billing didn’t want to make changes initially as they felt it would be difficult to know which insurance plan is now covering lactation visits and which ones were still grandfathered.

We have looked at the information on and attended webinars, but all the information is very ”generic” and not really helpful.

Is anyone successfuly getting reimbursed for outpatient lactation visits and what codes are you using?

Thank you for any help!
Roxanne :)

Roxanne Gollata, RN, IBCLC, RLC
Thedacare Physicians Outpatient Lactation Consultant
Encircle Health
2500 E Capitol Drive, Suite N2106
Appleton, WI 54911
Office: 920-358-1418
Appointments: 920-738-4600
Fax: 920-738-4792