Lactation Services Superbills 


This package of superbill receipts for lactation services and products is a critical component of establishing a successful practice infrastructure in the US.  These user-friendly superbills list the updated CPT and ICD-10 codes required by US insurance companies for reimbursement after October 1, 2015.

A BIG FEATURE:  Only codes shown by experience to be reimbursable by US insurance companies are listed, so your clients have a better chance of payment. Superbill-infant-V3.02-CUSTOM-BASIC_RedactedCodes in bold are the most likely to be reimbursed.pdf


Two versions are included in each package:

  1. Infant superbill
  2. Mother superbill

(A combined superbill version is no longer provided because all insurance companies require one superbill for each patient, mother and child. No other medical profession treats two people as a combined unit. If you still strongly prefer a combined superbill, it can be provided upon request at no extra charge.)
AvailnowThe new electronic fillable format features a functional, auto-calculating, fillable PDF for paperless offices or emailing to clients to fill out electronically.  No special software or programming is needed, just open it in the free Acrobat Reader and fill in the info.  Then save it and print as usual.  Very user-friendly. The standard PDF (hardcopy) version is also available.  It’s print-ready (reproduces sharply and cleanly) and perfect for three-part carbonless forms (white for insurance, yellow for client, pink for your client file). All formats include detailed instructions for optimal use and a copyright release for printing.


Please Note:  Our forms are designed to work with Adobe Reader and we guarantee that they will work with that program — if they don’t, we will troubleshoot and fix them.  They *may* work with other PDF programs, but we can’t guarantee or troubleshoot other programs.



Basic Non-Custom $40
Basic Custom $50
E-Fillable Non-Custom $60
E-Fillable Custom $70

(Discounted full sets available, see below)


1) Mother Individual Superbill         Buying Options

2) Infant Individual Superbill           Buying Options


Choose a package to fit your practice needs:

CUSTOM E-FILLABLE $150  — E-fillable, auto-calculating electronic PDF format customized with a well-designed header displaying your logo and practice information in stylized fonts. BONUS:  You also get both forms in the regular PDF format for hardcopy printing.
NON-CUSTOM E-FILLABLE $125 — E-fillable, auto-calculating electronic PDF format and fields to  add your logo (if you have one) and enter your basic practice information at the top of the page (no stylized fonts), using the free Acrobat Reader. BONUS:  You also get both forms in the regular PDF format for hardcopy printing.  Instantly downloadable.
CUSTOM BASIC $100 — Standard PDF format for hardcopy printing customized with a well-designed header displaying your logo and practice information in stylized fonts.
 NON-CUSTOM BASIC $75 — Standard PDF format for hardcopy printing.  Includes an editable region to add your logo (if you have one) and basic practice information at the top of the page (no stylized fonts), using the free Acrobat Reader. Instantly downloadable.

These forms have been designed for use by the IBCLC, which implies a clinical level of care beyond the normal course of breastfeeding, appropriate to the IBCLC level of training and certification.

Info from the fabulous medical billing guru Donna Sinnott, BBA, IBCLC, about IBCLC reimbursement and in-network billing

Info about the new ICD-10 codes

 Info about ICD-10 for lactation from the AAP

 Info from Breastfeed Chicago about insurance for breastfeeding services

Superbill Instructions

Customization Available!  Your superbill forms can be customized (your name, your business name, logo, NPI and FEIN numbers, contact info) as an upgrade option.  If you’ve already purchased your superbill forms and want a change OR now want to customize them, click here.

Non-customized forms can be downloaded instantly. Customized forms are delivered via email within one week or sooner for an expedited delivery fee.

Let me know if you have ideas about how to improve these forms.  Contact me for institutional pricing.

Originally developed in collaboration with my colleagues at Mahala Lactation and Perinatal Services, LLC, which I co-owned until Dec, 2014.