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Verified lactation details
Lactation and IBCLC Medicaid Billing
Medicaid lactation and IBCLC billing setup, with verified rows for Colorado, DC, Illinois, Missouri, Nebraska, Ohio, Vermont, and Virginia.
What is available
What is available
Billing details are verified for Colorado, DC, Illinois, Missouri, Nebraska, Ohio, Vermont, and Virginia. Other states do not have verified rates and billing requirements.
- Status
- partly verified
- Source checked
- CO/DC/IL/MO/NE/OH/VT/VA verified; other billing paths unverified
- Last updated
- 2026-06-30
States with official sources
Verified billing details are separated from unverified rates and billing requirements.
New York
NYS Medicaid Update: lactation counseling services
New York publishes Medicaid lactation-counseling billing guidance. IBCLC credential handling, rates, and billing steps are unavailable.
Colorado
Health First Colorado Lactation Support Services Billing Manual
Colorado publishes Health First Colorado lactation billing guidance and official S9443 modifier-combination rates for the listed in-person rows.
Illinois
Illinois HFS Fee Schedule For Lactation Counseling Services
Illinois publishes HFS lactation counseling fees for individual and group S9443 services provided by an IBCLC, CLC, or CLS. The listed in-person billing details are verified. Telehealth billing is unverified.
Ohio
Ohio Medicaid MISP Services Overview: Lactation Consulting Services
Ohio publishes Medicaid lactation consulting fees for S9443 and S9443-SY. Office and home billing details are verified for professional services outside hospitals, FQHCs, and RHCs. Facility and telehealth billing are unverified.
District of Columbia
DC DHCF Transmittal 19-20: Lactation Consultation Services
DC publishes Medicaid lactation consultation enrollment, code, rate, unit, visit, and postpartum-window guidance for the listed S9443 row.
Missouri
MO HealthNet Practitioner Fee Schedule Workbook
Missouri publishes MO HealthNet manual and fee-schedule support for the listed S9443 session of 30 minutes or more and its two-session pregnancy limit.
Nebraska
Nebraska DHHS Physician Services Fee Schedule
Nebraska publishes a January 2026 physician-services fee-schedule row for S9443 lactation counseling in the Prenatal Plus path. Other Nebraska lactation paths are unavailable.
Vermont
Vermont Medicaid Fee Schedule
Vermont publishes an active one-unit S9443 lactation-session row. S9445 modifier rules are unverified.
Virginia
Virginia DMAS Procedure Fee Files and CPT Codes
Virginia publishes an active DMAS fee for S9443 lactation consultant services and a provider fact sheet. The listed billing details are verified. Managed-care plans may require additional steps.
North Carolina
Clinical Coverage Policy 1-I: Dietary Evaluation and Counseling and Medical Lactation Services
North Carolina publishes a medical lactation services policy, but current rates and complete billing steps are unavailable.
Kansas
Kansas Medical Assistance Program Lactation Billing Manual
Kansas publishes KMAP lactation billing guidance. Current rates and telemedicine place-of-service handling are unverified.