IBCLC Billing Code Finder
Lactation billing uses standard E/M codes (99202–99205, 99212–99215) plus a small set of lactation-specific HCPCS codes. This tool walks you through visit type, duration or complexity, and which patient (mother or infant) you are billing under, and returns the most defensible code combination plus typical 2026 reimbursement ranges.
Last updated
CPT Code & Fee Finder
Answer 3 quick questions to find the right billing code, diagnosis codes, and fee range for your IBCLC visit.
Visit Type
Duration & Complexity
Duration
Complexity
Patient & Diagnosis
Who is the patient?
How this tool works
The finder is a three-step wizard. Step 1 asks whether the visit is new patient, established, or a follow-up. Step 2 captures total time spent on the date of service and the medical decision-making complexity. Step 3 asks whether you are billing under the mother (O-codes) or the infant (P-codes and Q-codes). It then returns the most specific CPT code that matches your inputs, suggested ICD-10 diagnoses, the documentation elements required to defend the code on audit, and rate ranges based on 2026 cash-pay and commercial reimbursement data. It does not submit claims and does not store entries.