MEDICAID BREAST PUMP ALERT
August 2016
Did you know that as of June 20, 2016 Medicaid’s Durable Medical Equipment Fee schedule covers breast pumps?
Questions & Answers:
Q: What Medicaid plan cover pumps?
A: A: Currently it is dependent on each Medicaid Managed Care Plan’s own criteria,
but by Florida law each Medicaid Managed Care Plan is to cover breast pumps.
(NO out of pocket expense for the mother)
Q: How long does it take to receive a pump?
A: Varies per policy.
Q: Can moms leave the hospital with a pump?
A: After pre-authorization most E0603 pumps are mailed to
your home by a (DME) Durable Medical Equipment who have contracts with the
Medicaid Managed Care Plan's to fulfill this product.
TAKE ACTION...
1.Request a pump from your Medicaid Managed Care Plan
Provide mom a prescription*
Direct moms to their insurance provider for DME information
Preauthorization required
*BREASTPUMP CPT CODES....
E0604 - Hospital Grade Rental Breast Pump, electric (AC and/or DC)
E0603 - Breast pump electric (AC and/or DC) any type
ICD-10 (DIAGNOSIS) CODES....
If prescription is for the MOTHER, use O92.5 Suppressed lactation
If prescription is for the BABY, use P92.5 (difficulties feeding at breast for 28 days or younger) & R63.3 (difficulties feeding over 28 days of age)
2. File a complaint, if you have any problems getting a breastpump from your Medicaid Managed Care Plan
If access to a pump is denied, click here to inform ACHA- they only track via this link
EVERYONE - doctors, nurse practitioners, lactation consultant, WIC employees and patients should complete a complaint form! The more who send complaints the faster Medicaid will get this system working smoothly!
3. Help with the policy
ACHA will be hosting a full day workshop this fall and needs our help with development
Add your ideas & comment on this BLOG
Medicaid Provider's can call 904-448-9727 and request them to send you their breast pump prescription forms for your office.
PLEASE HELP spread the word about download informational promotional flyer at http://flbreastfeeding.org/pdf/final_medicaidbreastpumpalert.pdf
Please add your comments as to your experience with getting breast pumps. These comments can be from anyone such as mothers, healthcare providers, WIC employees or even dads. To comment below, you will have to pick an option from the drop-down menu. Most the options require you sign-in with your gmail account or other type of account on the list, if you have no account just pick Anonymous! Your comments are important to help Florida Breastfeeding Coalition advocate for Medicaid breastfeeding mothers and babies.
Medicaid Provider's can call 904-448-9727 and request them to send you their breast pump prescription forms for your office.
PLEASE HELP spread the word about download informational promotional flyer at http://flbreastfeeding.org/pdf/final_medicaidbreastpumpalert.pdf
Please add your comments as to your experience with getting breast pumps. These comments can be from anyone such as mothers, healthcare providers, WIC employees or even dads. To comment below, you will have to pick an option from the drop-down menu. Most the options require you sign-in with your gmail account or other type of account on the list, if you have no account just pick Anonymous! Your comments are important to help Florida Breastfeeding Coalition advocate for Medicaid breastfeeding mothers and babies.
