On June 1, 2023, TennCare began reimbursing outpatient lactation visits for their TennCare Medicaid and CoverKids members. In order to provide these services, additional lactation professionals need to be trained and join the in-network benefits, as described below:

*When supervised and billed by a registered, in-network provider listed below, International Board-Certified Lactation Consultants (IBCLCs) with no additional medical licensure, Certified Lactation Specialists (CLSs), Certified Breastfeeding Specialists (CBSs), Certified Lactation Counselors (CLCs), and Certified Lactation Educators (CLEs) may provide lactation support to individuals with TennCare.

Supervising Providers include:

• Physicians (MDs/DOs)
• Physician Assistants (PAs)
• Nurse Practitioners (NPs)
• Certified Nurse Midwives (CNMs)
• International Board-Certified Lactation Consultants (IBCLCs) with healthcare licensure

If you are an IBCLC, CLC, or CLE that is employed by an in-network, contracted provider, you must bill under the supervising provider. To contract and credential with a TennCare MCO as an independent provider, IBCLCs must carry liability as an individual or through their practice group. They must also have one of the following licenses/credentials:

• Dentist
• Dietitian
• Midwife
• Nurse/RN
• Occupational Therapist
• Pharmacist
• Physical Therapist or Physiotherapist
• Physician or Medical Doctor
• Speech Pathologist or Therapist

NLCA White Paper:

Impact of the International Board Certified Lactation Consultant Improving maternal/infant health outcomes: Promoting equity in access to clinical lactation care.

TennCare Lactation Consultant Benefit & Billing Updates