There is no current industry standard for length of IBCLC visits. Other
therapists such as OT and PT bill in units of 15 min, 4 units for 1 hour, 8
units for 2 hours and so on. At a physical therapy center you may spend 15
min with the PT and then 45 min to 2 hours with the assistant while working
through an exercise program or receiving modalities. Unit billing allows the
flexibility to have the visit be the actual length of time needed for care.
Every mother and baby are different. Initial visits are often longer than
follow-up visits, but not always, this depends on the circumstances of
mother and baby at the time. 

 

As for group visits, while breastfeeding support groups commonly have
nursing mothers together talking, this is usually women with established
lactation in the normal course of breastfeeding, not for clinical care. This
would be billed as group education for which we have an existing code -
S9443. This code. However,  is often not a covered service from insurers. 

 

IBCLC individual, face-to-face visits are for clinical care from an allied
health professional. I don't think group clinical visits would ever be
appropriate. It would be uncomfortable at least, and a privacy issue,  to
take a clinical history (maternal, pregnancy, birth, infant) in a group
setting. Would you want 4 or 5 other women to know that you have a history
of herpes or depression or any other health condition, for example? Nor is
the physical exam of mother or baby appropriate within a group? Assessing
nipples is a private activity. Mothers in the early days of lactation are
exhausted and overwhelmed and concerned about their own baby. They are not
as likely to want company of other mothers at this point in time.  Mothers
at newborn visits are  also frequently accompanied by the father or a
grandparent or other support person. This is a key opportunity to educate
and gain buy-in of the supportive network for a mother, excluding them could
have a negative impact on breastfeeding since their opinions and support
have been shown to significantly affect breastfeeding duration.  A group of
mothers also would not likely want to be receiving help with positioning and
latch in front of these other people, even in the best case where she
wouldn't mind exposing her breast with other mothers. 

 

Judith L. Gutowski, BA, IBCLC, RLC

 


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