Breastfeeding as Business Tactic: Midwife Consulting for Profits

Breastfeeding as Business Tactic: Midwife Consulting for Profits



Are you passionate as a midwife to offer breastfeeding support? All midwives want the best option for feeding a baby. Consider the profitability of options for breastfeeding visits. You can either bill your insurance plan for a home visit for breastfeeding or an office visit. 

With the Affordable Care Act, most insurance plans cover breastfeeding visits one hundred percent (grandfathered insurance plans rarely cover this service; do a verification of benefits before providing any care to a woman and her babies to let you know what is covered by her insurance plan and what is a cash option for services with your practice). The insurance reimbursement for 30- to 60-minute visits ranges from $90 to $250, depending on the billing codes utilized.

Benefits of Breastfeeding

Breastfeeding Support

Breastfeeding support can be marketed with the benefits of breastfeeding stressing both newborn and mother aspects. Newborns have a lower chance of obesity, sickness, allergies, autoimmune conditions, and diabetes with prolonged breastfeeding. Mother’s metabolism is actually higher with breastfeeding than with pregnancy (demand of extra 500 calories/day versus 300 calories/day).

Longer breastfeeding decreases her chances of breast and ovarian cancer, obesity, diabetes, heart disease, and depression. Cost savings alone from breastfeeding compared to formula can be part of your marketing tactic.

Breastfeeding support can be focused on availability for problem visits. I like to stress marketing in the direction of prevention and education. Create breastfeeding educational topic timelines:

*Prenatal prep for initial latch techniques, skin-to-skin when the baby is born, and advocating for yourself and baby in the immediate postpartum period Women can be taught about breast pumps and how to get one prior to the baby’s arrival.

Immediate postpartum period

Either visit at home and at the hospital to help with colostrum transition and immediately get a good latch technique in place to help avoid cracked and sore nipples. Breastfeeding rates drastically decrease in the first 48 hours from lack of support from the health care team.

*First week after the baby comes: when the milk supply comes and engorgement sets in, many women have trouble with the latch. Sleep deprivation, frequent feedings, and the temptation of easy access bottles hinder breastfeeding success.

*Developmental stages of the newborn: teething, the introduction of food, and weaning

*Common problems that most breastfeeding support is sought after are nipple pain, poor latch techniques, cracked nipples, colicky baby, overabundance issues, poor milk supply, baby in NICU, failure to thrive, mastitis, and yeast infections

Lactation Consultants 

I have seen a few Lactation Consultants flourish by being independent contractors for Family Practice offices in an area of breastfeeding support. Midwives can do the same thing. We can add this charge to the global postpartum care currently being offered or strictly make a breastfeeding clinic our business model.

Find out the needs in your area. Are there any support groups for women to attend for breastfeeding? There are billing codes that cover the midwife offering these services. Prenatal and postpartum breastfeeding classes including support groups would be billing code S9443 (Lactation Classes, Non‐Physician Provider, Per Session). 

Office visits with Certified Nurse Midwives would be 99201-99205 new patients depending on time spent with pt (10-60min). Established patients would be 99212-99215 depending on time (10-60min). Your note for the visit needs to stress more than 50% of the visit was spent counseling and write the exact time spent in front of the patient.

Home Visits

Home visits are paid if the patient’s insurance plan has home visit coverage. Those billing codes are 99341-99345 for new patients and 99346-99350 for established patients depending on time spent and complexity. Code 99404 can be used if a Lactation Consultant is seeing the patient in your office.

Short and long-term benefits to the community of supporting breastfeeding need to be promoted. Having financial backing to your cause only makes it that much sweeter!