Effective July 1, 2022, for claims with dates of service beginning July 1, 2022 and after, Donor Human Breast Milk is covered for Medicaid and CHIP members, ages 0-6 months, in the inpatient hospital setting. Providers must bill for Donor Human Breast Milk utilizing CPT code T2101. The reimbursement rate is $4.89 per ounce/unit. The maximum number of allowable ounces/units is 15 ounces/units per day. The maximum allowable units per member, per lifetime is 1,260 units.
Should you have additional questions or concerns, please contact the Gainwell Technologies Call Center at 770-325-9600 or 1-800-766-4456 or contact us at www.mmis.georgia.gov.