Is anyone out there working to get a provider code for IBCLCs for insurance reimbursement?
Does anyone have information on this?
Marsha Walker, I know you are very active and knowledgeable in this area.
Registered dieticians petitioned the CMS and AMA for them which resulted in their receiving their "independent" provider status for consultations.
I'm working for a military hospital so my patients are on Tricare. Last year, Tricare, put out a new policy which states 6 lactation visits are covered per birth experience. Since IBCLCs (RN/IBCLC) do not have provider codes, we are not considered providers. I don't have any figures but I know reimbursement (RVUs) is minimal and the current code we must use CPT 99211 is "typically 5 minute" encounter. All of you on Lactnet know our consults are mostly over 45 minutes in length. This code doesn't even reflect our workload.
We have a group of IBCLCs who would like to look into this. I wanted to see if any of you know where we stand.
Kris Nilson BSN RN IBCLC
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