Kara,
Covering prenatal classes & support groups is part of the ACA when it goes
over exactly what is covered under the act (it states support & pumps but
the full part discusses classes, support groups & breastfeeding aids).
When I sent in the CPT codes and what they would pay some had nothing (home
visit codes) but prenatal education, group counseling (which I take to mean
support group) and the other codes we have been using for visits all had a
reimbursement amount. So I assume that if someone couldn't find an
in-network person they could get reimbursed whatever they would pay for that
region like they do for the consults. Don't know since I am in network.
Felicia L Henry, BCCE, IBCLC
Oxnard, CA
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