Medicaid Redesign Team Change Effective
May 1, 2013

Date Issued: 5/1/2013

Lactation Counseling Payment

As of May 1, 2013, EmblemHealth provides reimbursement for lactation counseling (CPT codes S9445 and S9446) provided by an EmblemHealth-credentialed International Board Certified Lactation Consultant (IBCLC) who is a licensed or registered:

  • Midwife (MW)
  • Nurse Practitioner (NP)
  • Physician
  • Physician Assistant (PA)
  • Registered Nurse (RN)

Breastfeeding education and lactation counseling services billed with other appropriate CPT codes are also reimbursed in accordance with rates established in provider agreements. Out-of-state network practitioners are reimbursed at negotiated rates.

Practitioners who wish to be credentialed to provide lactation counseling services may call 1-866-447-9717, option 5.