MedicaidCoverageMedium impact
Certified Lactation Consultants Eligible to Provide Breastfeeding Instruction Sessions
Nebraska Medicaid·NE · OB-GYN, Family Medicine, Pediatrics·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
Jul 1, 2026
Summary
Effective July 1, 2026, Nebraska Medicaid now recognizes certified lactation consultants (CLCs) as an allowable provider type for breastfeeding instruction sessions (code S9443) under the Prenatal Plus Program, in addition to licensed medical nutrition therapists and international board-certified lactation consultants. This service is limited to once per pregnancy.
Action Required
By June 30, 2026: Billing team must update billing system and provider credentialing records to recognize certified lactation consultants (CLCs) as eligible providers for HCPCS code S9443 breastfeeding instruction sessions. Verify that your practice's billing software allows CLCs to bill this code and that encounter forms identify CLC as a valid provider type for Prenatal Plus Program services. Update any internal provider directories and ensure front desk/scheduling staff know that CLCs can now deliver this service. Confirm with your Nebraska Medicaid contract manager if your organization plans to employ or contract with CLCs. Failure to recognize CLCs as eligible providers may result in claim denials for otherwise valid services.