[Ohio] Access to Lactation Consulting Services for Medicaid Beneficiaries

By February 28, 2025: Billing team must verify which eligible practitioners in your practice hold IBCLC certification (Dentists, Dietitians, Doulas, Registered Nurses, Licensed Practical Nurses, Occupational Therapists, Pharmacists, Physical Therapists, and Speech Therapists). For those with IBCLC credentials, update billing system to enable billing of HCPCS code S9443 ($59.08) for office-based lactation consulting and S9443-SY ($154.38) for home visit lactation consulting to Ohio Medicaid patients. Ensure providers document IBCLC certification in credentialing files and that encounter forms capture visit location (office vs. home) to support correct code selection. Contact CareSource at (800) 324-8680 for enrollment verification or questions about reimbursement. Failure to properly credential IBCLC practitioners or use incorrect modifiers may result in claim denials.