{"name":"DoulaPaid Lactation and IBCLC Medicaid Billing Verified Source Dataset","version":"2026","status":"some billing rows verified","publicationStatus":"some billing rows verified","siteLocation":"published under DoulaPaid","reviewStatus":"mixed status","license":"https://creativecommons.org/licenses/by/4.0/","requiredAttribution":"DoulaPaid, \"Lactation and IBCLC Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026","canonicalReport":"https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026","distributions":{"csv":"https://doulapaid.com/lactation-medicaid-reimbursement-dataset.csv","json":"https://doulapaid.com/lactation-medicaid-reimbursement-dataset.json"},"rows":[{"vertical":"lactation","state_code":"NY","state_name":"New York","status":"rates under review","publication_status":"open for official-link checks","site_location":"published under DoulaPaid","review_status":"official source found; rates under review","source_checked_at":"2026-06-25","coverage_summary":"New York publishes Medicaid lactation-counseling billing guidance. DoulaPaid has not published IBCLC credential handling, rates, or billing steps.","billing_question":"Which billing provider, certification, code, and plan path applies before New York lactation counseling can be billed?","credential_question":"How should the product distinguish IBCLC certification, licensed clinicians, midwives, physicians, and other lactation-support roles?","official_source_label":"NYS Medicaid Update: lactation counseling services","official_source_url":"https://www.health.ny.gov/health_care/medicaid/program/update/2022/no07_2022-06.htm","official_source_publisher":"New York State Department of Health","canonical_page_url":"https://doulapaid.com/lactation/new-york","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Lactation and IBCLC Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026"},{"vertical":"lactation","state_code":"CO","state_name":"Colorado","status":"verified for listed billing rows","publication_status":"verified billing rows can be used","site_location":"published under DoulaPaid","review_status":"rates verified","source_checked_at":"2026-06-25","coverage_summary":"Colorado publishes Health First Colorado lactation billing guidance and official S9443 modifier-combination rates. DoulaPaid has verified in-person S9443 billing details for the listed rows.","billing_question":"Which Colorado lactation provider enrollment, credential, service, and billing requirements are needed before setting up billing?","credential_question":"How should a billing tool handle the difference between lactation support, IBCLC affiliation, doula affiliation, and billing provider type?","official_source_label":"Health First Colorado Lactation Support Services Billing Manual","official_source_url":"https://hcpf.colorado.gov/lactserv-manual","official_source_publisher":"Colorado Department of Health Care Policy and Financing","canonical_page_url":"https://doulapaid.com/lactation/colorado","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Lactation and IBCLC Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026"},{"vertical":"lactation","state_code":"IL","state_name":"Illinois","status":"verified for listed billing rows","publication_status":"verified billing rows can be used","site_location":"published under DoulaPaid","review_status":"rates verified","source_checked_at":"2026-06-25","coverage_summary":"Illinois publishes an HFS lactation counseling fee schedule with S9443 individual and group rows for IBCLC, CLC, and CLS services. DoulaPaid has verified in-person packets for those rows; telehealth is not published yet.","billing_question":"Which Illinois credential, individual or group setting, diagnosis, and unit count applies before selecting the verified S9443 billing row?","credential_question":"How should the workflow distinguish IBCLC, CLC, and CLS credentials before applying Illinois modifiers and group billing rules?","official_source_label":"Illinois HFS Fee Schedule For Lactation Counseling Services","official_source_url":"https://hfs.illinois.gov/content/dam/soi/en/web/hfs/sitecollectiondocuments/12192024lactationfs.pdf","official_source_publisher":"Illinois Department of Healthcare and Family Services","canonical_page_url":"https://doulapaid.com/lactation/illinois","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Lactation and IBCLC Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026"},{"vertical":"lactation","state_code":"OH","state_name":"Ohio","status":"verified for listed billing rows","publication_status":"verified billing rows can be used","site_location":"published under DoulaPaid","review_status":"rates verified","source_checked_at":"2026-06-25","coverage_summary":"Ohio publishes Medicaid lactation consulting service rows for S9443 and S9443-SY. DoulaPaid has verified professional non-hospital, non-FQHC, non-RHC packets for office and home lactation consults; facility and telehealth paths are not published yet.","billing_question":"Which Ohio service setting, billing provider type, diagnosis, and place of service applies before the verified S9443 or S9443-SY row can be used?","credential_question":"Which Ohio lactation consultant credential and provider-enrollment pathway should be verified before treating a facility, FQHC/RHC, or dietitian path as ready for billing?","official_source_label":"Ohio Medicaid MISP Services Overview: Lactation Consulting Services","official_source_url":"https://dam.assets.ohio.gov/image/upload/medicaid.ohio.gov/Families%2C%20Individuals/Programs/MISP/MISP_Services_Overview_V_2.1_FINAL_DRAFT_3.16.2026_Clean.pdf","official_source_publisher":"Ohio Department of Medicaid","canonical_page_url":"https://doulapaid.com/lactation/ohio","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Lactation and IBCLC Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026"},{"vertical":"lactation","state_code":"NC","state_name":"North Carolina","status":"rates under review","publication_status":"open for official-link checks","site_location":"published under DoulaPaid","review_status":"official source found; rates under review","source_checked_at":"2026-06-25","coverage_summary":"North Carolina publishes medical lactation services policy, but the current official fee-schedule artifact requires additional authenticated or published rate confirmation. DoulaPaid has not published rates or billing steps.","billing_question":"Which North Carolina code, modifier, provider type, and fee-schedule rate must be confirmed before a lactation packet can be modeled?","credential_question":"Which North Carolina medical lactation provider credentials and supervision rules apply before a provider can be treated as billable?","official_source_label":"Clinical Coverage Policy 1-I: Dietary Evaluation and Counseling and Medical Lactation Services","official_source_url":"https://medicaid.ncdhhs.gov/1-i-dietary-evaluation-and-counseling-and-medical-lactation-services/download?attachment=","official_source_publisher":"North Carolina Medicaid","canonical_page_url":"https://doulapaid.com/lactation/north-carolina","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Lactation and IBCLC Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026"},{"vertical":"lactation","state_code":"KS","state_name":"Kansas","status":"rates under review","publication_status":"open for official-link checks","site_location":"published under DoulaPaid","review_status":"official source found; rates under review","source_checked_at":"2026-06-25","coverage_summary":"Kansas publishes KMAP lactation billing manual guidance, but direct rate verification and telemedicine place-of-service handling still need review. DoulaPaid has not published rates or billing steps.","billing_question":"Which Kansas code, rate, modifier, telemedicine place of service, and billing-provider requirement must be verified before packet generation is safe?","credential_question":"Which Kansas lactation-provider credentials and KMAP enrollment requirements apply before a provider can be treated as billable?","official_source_label":"Kansas Medical Assistance Program Lactation Billing Manual","official_source_url":"https://www.kdhe.ks.gov/DocumentCenter/View/53300/Lactation-Billing-Manual-PDF","official_source_publisher":"Kansas Department of Health and Environment","canonical_page_url":"https://doulapaid.com/lactation/kansas","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Lactation and IBCLC Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-lactation-medicaid-reimbursement-2026"}]}