On September 1, 2026, the nation’s largest health insurer is poised to slash reimbursement for breastfeeding care services. 

Key Takeaways:

• Lactation counselors will no longer be able to bill for caring for both mothers and babies — a reduced reimbursement.

• Reimbursement requests for the care of both mother and baby reflects that lactation counselors are serving two patients, not just one.

The Details:

According to a June 2026 Reimbursement Policy Update Bulletin from UnitedHealthcare, starting September 1, lactation counselors will no longer be able to bill for their care of both mothers and babies. Instead, only care for the mother will be considered billable. 

Per the bulletin, “In alignment with Centers for Medicare and Medicaid Services, (CMS) code S9443 will be considered for reimbursement when a claim is submitted listing the mother as the patient. Claims submitted for the code S9443 for an infant will not be considered for reimbursement.” 

While UnitedHealthcare is the first insurance company to announce the reduced reimbursement, parents and lactation counselors alike recognize that other insurers may quickly follow suit. 

Zoom In:

On the surface, it might look like lactation consultants are double-billing insurance.

The tension between interconnectedness and independence is at the heart of former abortion practitioner Dr. John Bruchalski’s insistence that OB/GYN medicine must care for both patients, the mother and the child. The child, both in the womb and out, depends on his mother for survival, but there remain two distinct persons, not one. 

This is why lactation care, whether given by a certified lactation counselor (CLC) or an international board-certified lactation consultant (IBCLC), is right to bill for two patients, both members of the mother-infant dyad. 

Historically, UnitedHealthcare and other insurers have reimbursed lactation care services billed for both mothers and babies, although they technically don’t have to, for one simple reason: women’s preventive services — which have to be covered under the Affordable Care Act at 100% without a deductible or co-pay — apply, by definition, to the woman only. 

This means that while UnitedHealthcare and other insurance companies have reimbursed charges for mothers and babies, they are not legally required to do so. 

The Big Picture:

There’s value in meeting with a lactation consultant before the baby is born. But for most moms and babies, lactation care enters the picture because there’s an issue with feeding.

An initial in-home visit (or in-office, if the mother and baby travel to the lactation consultant) includes:

• taking a medical history of both the mother and the infant

• weighing the baby before and after a feeding

• observing baby’s latch and suckling during a feeding

• assessing for tongue tie or anatomical issues with baby’s palate

• addressing maternal pain with nursing or cracked or bleeding nipples

• advising what to do for inverted nipples

• educating and observing different nursing positions for optimal support and comfort and feeding

• identifying and troubleshooting milk supply issues

• answering questions about pumping and assisting with obtaining a pump and supplies

• demonstrating active listening and concern for maternal stress related to her baby’s weight gain, supply issues, or pain

Over the course of multiple visits, the mother and counselor’s rapport strengthens and the counselor evaluates whether previous education and interventions made a difference. Has mom’s pain resolved or at least greatly diminished? How is the baby's weight gain? Are further referrals (such as for severe tongue tie or lip tie) necessary? 

Why It Matters:

In the short-term, reimbursing lactation services at half the cost saves insurance companies money. But what happens when women and infants don’t receive the care they need to successfully breastfeed at least some of the time, let alone exclusively? 

We already know that six months of exclusive breastfeeding reduces risk of “[a]sthma, severe lower respiratory disease, obesity, Type 1 diabetes, acute otitis media (ear infections), sudden infant death syndrome (SIDS), gastrointestinal infections, which can cause diarrhea and vomiting, [and] necrotizing enterocolitis (NEC) (death of intestinal tissue) for preterm infants.”

Live Action News previously covered why more, not less, breastfeeding support could be especially helpful for black mothers and babies, who are disproportionately more likely to die in the year after birth compared to their counterparts of other ethnicities. 

We know, too, that breastfeeding mothers have lower rates of ovarian cancer, breast cancer, Type 2 diabetes, and high blood pressure — and, according to some research, lower rates of postpartum depression. 

And yet fewer than 1 in 3 babies are exclusively breastfed at six months, let alone breastfed at all until two years of age “or beyond,” as recommended by the World Health Organization and the American Academy of Pediatrics. 

A press release representing the International Board of Lactation Consultant Examiners (IBLCE), the American College of Nurse-Midwives (ACNM), and the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) reflected the long-term net loss if insurance companies fail to prioritize and adequately compensate lactation care:

Suboptimal breastfeeding has been estimated to cost the United States more than $3 billion a year in excess medical costs (in 2014 dollars), and global analyses put economic losses in the hundreds of billions. When combining the US medical, non-medical, and premature death-related cost of not breastfeeding, this number exceeds $25 billion in 2026 dollars. 

The Bottom Line:

The joint IBLCE, ACNM, and AWHONN statement called the solution to the reimbursement change “straightforward,” urging insurance companies to “either support a companion code that reimburses the child’s care, or properly reflect the rate on the available code so it reflects that one visit treats two interdependent patients.” 

The signers acknowledged, “Fair reimbursement and evidence-based care does not have to mean unlimited cost,” but pointed out that “a roughly 50 percent cut, with no offsetting increase, goes further than sustainability requires, and it risks higher spending on the poorer outcomes that follow when families lose access to this care.”