Telehealth

The address on file may not be today’s location A counseling patient logs in from a familiar account, but today they are visiting relatives in another state. Their insurance card and home address have not changed. Their physical location has. Before the session proceeds, the practice needs to determine whether the clinician has authority to provide care where the patient is located. HHS describes several possible interstate pathways, including a full license, qualifying tempo

There is an important distinction providers—and health plans—need to understand: Being a virtual-only provider is legitimate. Listing a mailbox or virtual mailing address as though it were a physical practice location is something entirely different. Providers increasingly deliver care through telehealth, mobile services, home visits, and other nontraditional practice models. Major payers have systems designed to accommodate those models. You do not need to pretend to have a

Effective immediately, Georgia Medicaid now requires the initial lactation consultation to be provided in person before any follow-up services may be delivered via telehealth. While telehealth continues to play an important role in improving access to lactation care, this policy changes how Georgia Medicaid beneficiaries begin treatment and may require providers to adjust scheduling workflows. What Changed? Under Georgia Medicaid’s updated policy: The first lactation visit mu

As more lactation consultants provide care through telehealth, we’ve identified what appears to be a significant compliance issue affecting many RN/IBCLCs. The misconception is simple: “I’m contracted as an IBCLC, so only the IBCLC rules matter.” Unfortunately, that’s often not how state nursing boards view it. Your Highest Professional License Still Matters An IBCLC is a professional certification. A Registered Nurse is a state-licensed healthcare professional. Those are not

And why TRICARE is the exception—not the rule. One of the most common questions we receive is: "Why don't you bill 99404 for telehealth lactation visits?" The answer is simple: Because billing should follow the payer's published policy—not just what happens to pay. While some billing companies routinely submit 99404 for commercial telehealth lactation visits, we generally do not. The one major exception is TRICARE, which has a unique breastfeeding benefit that specifically re

The short answer is yes—but whether you'll be paid depends on the patient's insurance plan, the payer's policies, and how the visit is documented and billed. Telehealth has become an important tool for lactation care, allowing IBCLCs to support families who may otherwise have difficulty accessing services. However, unlike many other healthcare specialties, telehealth coverage for lactation services is far from consistent. Understanding when telehealth is covered—and when it i