Medicaid coverage for lactation consultant services is varied and inconsistent across states. If the service is covered, only healthcare professionals who hold a medical or nursing license are eligible for Medicaid reimbursement. Since the IBCLC credential is a certification, not a license, Medicaid beneficiaries often lack access to the services of IBCLCs. Reimbursement codes provide an extremely low reimbursement rate.

Advocacy opportunity: Ask your state Medicaid Department to support legislation that would license IBCLCs. Once licensed, ask your state Medicaid Department to submit a State Plan Amendment (SPA) requesting permission from the federal CMS office to reimburse for the clinical services delivered by licensed IBCLCs. If after much work, licensure efforts are not successful, then consider asking for a SPA requesting permission from the federal CMS office to reimburse for clinical services delivered by non-licensed IBCLC providers.