Breastfeeding Billing Tips: Midwife Lactation Team

Are you passionate as a midwife to offer breastfeeding support? All midwives want the best option for feeding a baby. Consider the profitability options for breastfeeding visits. You can either bill to insurance plans a home visit for breastfeeding or office visit. With the Affordable Care Act, most insurance plans cover breastfeeding visits one hundred percent (grand fathered insurance plans rarely cover this service – do a verification of benefits before providing any care to women and her babies to let you know what is covered by her insurance plan and what is a cash option for services with your practice). The insurance reimbursement for 30-60min visits range from $90-250 depending on billing codes utilized.

Breastfeeding support can be marketed with benefits of breastfeeding stressing both newborn and mother aspects. Newborns have lower chance of obesity, sickness, allergies, automimmune conditions, and diabetes with prolonged breastfeeding. Mother’s metabolism is actually higher with breastfeeding than pregnancy (demand of extra 500 calories/day versus 300 calories/day). Longer mother breastfeeds decreases her chances of breast and ovarian cancer, obesity, diabetes, heart disease, and depression. Cost savings alone from breastfeeding compared to formula can be part of your marketing tactic.

Breastfeeding support can be focused on availability for problem visits. I like to stress marketing in a direction of prevention and education. Create breastfeeding educational topic timelines:
*Prenatal prep for initial latch techniques, skin to skin when baby is born, advocating for yourself and baby in the immediate postpartum period. Women can be taught about breast pumps and how to get one prior to baby’s arrival.

• Immediate postpartum period: either visit at home and at the hospital to help with colostrum transition and immediately getting a good latch technique in place to help avoid cracked and sore nipples. Breastfeeding rates drastically decrease the first 48hrs from lack of support of health care team.
• First week after baby comes: when the milk supply comes and engorgement sets in, many women have trouble with latch. Sleep deprivation, frequent feedings, and temptation of easy access bottles hinder breastfeeding success.
• Developmental stages of newborn: teething, introduction of food, and weaning
• Common problems that most breastfeeding support is sought after are nipple pain, poor latch techniques, cracked nipples, colicky baby, over abundance issues, poor milk supply, baby in NICU, failure to thrive, mastitis, and yeast infections

I have seen a few Lactation Consultants flourish with being independent contractors for Family Practice offices in an area as breastfeeding support. Midwives can do the same thing. We can add this charge to the global postpartum care currently being offered or strictly make a breastfeeding clinic as our business model.

Find out the needs in your area. Are there any support groups for women to attend for breast feeding? There are billing codes that cover the midwife offering these services. Prenatal and postpartum breastfeeding classes including support groups would be billing code S9443 (Lactation Classes, Non‐Physician Provider, Per Session). Office visits with Certified Nurse Midwife would be 99201-99205 new patient depending on time spent with pt (10-60min). Established patients would be 99212-99215 depending on time (10-60min). Your note for visit needs to stress more than 50% of visit was spent counseling and write exact time spent in front of patient.

Home visits are paid if patient’s insurance plan has home visit coverage. Those billing codes are 99341-99345 for new patients and 99346-99350 for established patients depending on time spent and complexity. Code 99404 can be used if a Lactation Consultant is seeing patient in your office. Short and long term benefits to community of supporting breastfeeding need to be promoted. Having a financial backing to your cause only makes it that much sweeter!
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Reference
https://midwiferybusinessconsultation.com/breastfeeding-as-business-tactic-midwife-consulting-for-profits/