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Updates to Breast Pump Device Policies for USFHP Members
Johns Hopkins HealthCare LLC (JHHC) has applied updates and clarifications to the breast pump device policies for Johns Hopkins US Family Health Plan (USFHP) members. Beginning April 12, 2019:
|Electric Breast Pump (E0603)/ Standard/Manual Breast Pump (E0602)Hospital Grade Pumps (E0604)||Hospital Grade Pumps (E0604)|
Breast Pump Policy Reminders
- A prescription from an authorized provider is required for breast pumps and equipment.
- Breast pump kits, which are specific to each manufacturer, are covered. These kits provide the necessary supplies to pump from both breasts simultaneously.
- Lactation counseling (99401-99404)
- Services must be rendered by a TRICARE authorized provider
- No cost shares are associated with lactation counseling
- Up to 6 outpatient lactation counseling session are covered per birth event.
- Excluded items include:
- Breast pump batteries, battery powered adapters, battery packs
- Regular baby bottles, nipples, caps and lids
- Travel bags and other carrying accessories
- Cleaning supplies
- Baby weight scales
- Garments and other products that allow hands free pump operation
- Ice packs, labels, labeling lids
- Nursing bras, bra pads
- OTC creams and ointments
- Breast pumps with “luxury or deluxe” features such as smart phone connectivity, Bluetooth features, rechargeable batteries, luxury tote bags, and car adapters. Members may elect to purchase these items and pay the difference between the TRICARE allowable amount and the actual cost of the item.