MedicaidCoverageMedium impact
Request for Comment - Adding lactation consultants to Medicaid State Plan - Comments due April 16, 2020
Oregon Health Plan·OR · OB-GYN, Pediatrics, Family Medicine +1 more·Public notice
We identified it
Aug 19, 2026
Summary
Oregon Medicaid is requesting public comments on a proposed State Plan Amendment to add licensed lactation consultants as an eligible provider type for Medicaid services. Currently, lactation consultations are only covered when performed by medical professionals in hospital settings. This expansion, authorized by HB 2503 (2017), would allow OHA-licensed lactation consultants (meeting International Board Certified Lactation Consultant standards) to bill Medicaid directly. The public comment period ends April 16, 2020.
Action Required
By April 16, 2020: Medical billing team should review this public notice and determine if the practice has comments to submit regarding the proposed lactation consultant provider type addition. If the practice employs or works with lactation consultants, consider submitting feedback to jesse.anderson@dhsoha.state.or.us. Once the State Plan Amendment is approved by CMS (expected after the comment period), billing team must: (1) verify if your practice employs OHA-licensed lactation consultants, (2) identify or research appropriate billing codes for lactation consultant services once they are established, (3) update billing software and credentialing files to recognize lactation consultants as eligible Medicaid providers, (4) train staff on billing procedures for these services. Monitor OHA website for final SPA approval notice and implementation date.