Childbirth and Breastfeeding Support Demonstration: Claims and Reimbursement
Claims and Reimbursement Information
Services |
Reimbursement Information |
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Breastfeeding Support Services (Lactation)
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Individual Lactation Consulting
- CPT® code 99401 – 15 minutes
- CPT code 99402 – 30 minutes
- CPT code 99403 – 45 minutes
- CPT code 99404 – 60 minutes
Group Lactation Consulting
- CPT code 99411 – 30 minutes
- CPT code 99412 – 60 minutes
If rendered via telehealth, include the appropriate modifier (GT or 95)
*Services limited to six visits total
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Doula Support Services |
Antepartum and Postpartum
- CPT code 99509
- Six visits total
- Support is untimed and is per single birth event
- Place of service is limited to residence/home (POS-12)
Continuous Labor Support
- CPT code 59899
- Reimbursement is 15 x CPT code 99509
- Support is untimed and is per single birth event
- Care is not covered at military hospitals or clinics
- Place of service is limited to:
- Hospital (POS-21)
- Birthing center (POS- 22)
- Home (POS- 12)
Please note:
- Telehealth visits are not covered for doula services
- Certified labor doula services not personally performed will not be reimbursed
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The provider’s National Provider Identification (NPI) number must be on all claims. To learn more about NPIs, visit our NPI page.
View current rates at www.health.mil/rates. You must select your locality or ZIP code.
CPT® is a registered trademark of the American Medical Association. All rights reserved.