Insurance

Nurture strives to offer quality, in-home lactation services to ALL families. We have made great progress working toward this goal, and are continually working to improve access to IBCLC lactation services. Here are our current options for covered or discounted services with Nurture:

Anthem/BCBS

Nurture is in-network this plan. Applies to non-Medicaid plans only. Deductibles/Coinsurance may apply.

United Healthcare/UMR

Nurture is in-network this plan. Applies to non-Medicaid plans only. Deductibles/Coinsurance may apply.

Medical Mutual

Nurture is in-network this plan. Applies to non-Medicaid plans only. Deductibles/Coinsurance may apply.

OSU/Luminare

OSU employee insurance covers 6 lactation visits at 100%. Nurture will submit your claims on your behalf for no out of pocket expenses. If you are an OSU Health Plan member you qualify for the Buckeye Baby Program, Click Here to take advantage of all this program has to offer!

Cigna

Nurture partners with Wildflower for Cigna insurance coverage. Wildflower offers 100% coverage with no out of pocket fees for clients. To verify Wildflower coverage Click Here. Once approved you can schedule your appointment with Nurture and we handle the rest.

Aetna

Nurture partners with The Lactation Network (TLN) for Aetna insurance coverage. TLN provides 3-6 lactation visits at 100% coverage. To verify TLN coverage Click Here. Once approved with TLN, you can schedule your appointment with Nurture and we handle the rest.

VA Veterans

Nurture partners with The Lactation Network (TLN) for VA Veterans insurance coverage. TLN provides 6 lactation visits with 100% coverage. To verify TLN coverage Click Here. Once approved you can schedule your appointment with Nurture and we handle the rest.

Out Of Network Plan Options

(1) Nurture will submit an insurance claim for you, if you provide your insurance information on your intake form. This means you self pay and we submit an insurance claim on your behalf requesting reimbursement. Any funds reimbursed will be sent to you directly from your insurance company.

(2) Use a health savings HSA card to cover the expense of your vists.

(3) Consider requesting Gap Coverage or Network Deficiency. This means your insurance plan will bill an out-of-network provider as an in-network provider. If approved, you would pay Nurture directly as Self Pay, we submit an insurance claim to your company, and they reimburse you directly. We typically bill procedure code s9443 & 99404 and diagnosis code z39.1. Nurture does not submit paperwork or make calls for gap coverage at this time. Page 8 of this document provides a nice script for requesting lactation coverage: National Women’s Law Center Breastfeeding Tool Kit.

Self Pay Rate Discount

Nurture offers a 20% discount for self pay. This rate is listed on our scheduling page. Self Pay Rate clients pay in full upon completion of consultation.

Medicaid

We offer a discounted Medicaid/WIC rate for all of our lactation services. Discounted consultations cannot be submitted to insurance companies for reimbursement. We continue to advocate for lactation coverage for all families.

Hardship Fund

Nurture operates a pay-it-forward hardship fund, supported by contributions from clients and community partners. These funds allow us to reduce or waive fees for families with financial need. Nurture is a for-profit company and contributions are not tax-deductible.

To apply for our Hardship Fund, please complete this form.

To contribute to our Hardship Fund, please click here and select “Pay It Forward”


Coverage Considerations for Mother and Baby:

The Affordable Care Act (ACA) requires most insurance plans to cover preventive services without cost-sharing (no co-pays or deductibles). This includes comprehensive lactation support and counseling for pregnant and nursing women from certified lactation consultants for the duration of breastfeeding.

If you would like to verify insurance coverage prior to your consultation, please call the number on the back of your insurance card to confirm coverage consistent with the below coding.

Lactation-Specific Codes

S9443 is a code specifically for lactation services. While this code is frequently covered by insurers, the reimbursement rate often does not align with the level of care provided during lactation consultations.

Home Visiting Codes for Preventive Services

Additional home visiting codes exist for behavioral counseling and evaluation. When these codes are used in combination with Modifier 33, they indicate preventive services which include lactation care, and should be covered per Affordable Care Act Law. Insurance companies may not recognize this and instead apply the cost of these preventive counseling and evaluation codes to deductible or co-pay. We encourage clients to advocate for coverage of these codes per the Affordable Care Act and ensure that their insurance company is not limiting “100% coverage” to just the S9443 code.

Example Coding for Preventive Services

  • CPT 96156, Modifier 33
  • CPT 99404, Modifier 33
  • CPT 99344, Modifier 33

The following information may assist you in determining insurance coverage for individual claims related to both mother and baby:

Nurture Columbus
Phone: 614-407-4305
Fax: 614-586-9148
EIN: 825063531
Procedure Codes: S9443, 99404, 99344, 96156 (modifier 33)
Diagnosis Codes: Z39.1, O92.70, Z34.8 (prenatal), Z76.2 (infant)
Location Codes: 12 (in-home), 10 (telehealth)
Practitioner NPI numbers:
Allyson Wessells, PT, IBCLC
NPI: 1649661430
IBCLC L-58094

Angela Cleary, IBCLC
NPI: 1982328092
IBCLC L-307473

Candice Myers, IBCLC
NPI: 1184314502
IBCLC L-309972

Gina Giavasis, RD, IBCLC
NPI: 1396530200
IBCLC: L-315288

Joanne Erbe, RN, IBCLC
NPI: 1508525692
IBCLC L-64864

Julie Oberholzer, MPH, IBCLC
NPI: 1881943264
IBCLC L-33276

June Myers, IBCLC
NPI: 1861071938
IBCLC L-25810

Brittney Gibson, IBCLC
NPI: 1942933668
IBCLC L-306963

Delaney Shumaker, RN, IBCLC
NPI: 1396604013
IBCLC L-320265

Insurance information is collected with your intake form after scheduling. A credit card will be required when scheduling and held on file for cancelations. A cancelation fee of $50 is charged for cancelations with less than 24 hours notice.

Thank you for choosing Nurture!