To align with current Medi-Cal billing guidance, the Alliance is updating its billing requirements for lactation services. Effective September 1, 2026, CPT® codes 98960–98962 will no longer be accepted for reimbursement when billed for lactation services.
While these codes are currently recognized as an Alliance benefit under the community health worker (CHW) program, lactation services provided by registered nurses, registered dieticians, certified nurse midwives, nurse practitioners or certified lactation consultants should bill with the appropriate Evaluation and Management (E&M) code based on the level of service provided.
For more information on covered lactation services, please review the Pregnancy-Related Services section of the DHCS Medical Services Provider Manual.
If you have questions regarding this billing update, please contact the Claims Customer Service team at 831-430-5503.
