Donor Milk for Babies in the Hospital

In New York State donor milk is a tissue and hospitals require a license by the New York State Department of Health. The Blood and Tissue Resources (hyperlink to:

https://www.wadsworth.org/regulatory/tissue-resources) licenses milk banks. Hospitals that use donor milk must have their policies and procedures in place. Below you can download the application and our guidelines on the Ten Steps to Using Donor Milk in the hospital. NYMB has sample hospital policies and can provide them on request. Our executive director is happy to offer a presentation on donor milk if your hospital wants more information on using donor milk.

IF YOUR BABY IS HOSPITALIZED

Pasteurized donor human milk is now available in almost thirty-one hospitals in New York State. The hospital orders milk for its babies especially for premature and sick infants while encouraging mothers to pump and establish a full milk supply. In addition some hospitals are beginning to supplement with donor milk for full term infants when mom’s own milk is delayed in becoming established. Some hospitals are also discharging babies on donor milk from the hospital. If your baby is discharged from the hospital on donor milk and you have a letter of medical necessity, NYMB will do everything possible for your insurer to pay for donor milk.

If your baby is discharged on donor milk without a letter of medical necessity, you still need a prescription. In this case you are responsible for the processing fee.

DONOR MILK IS NOW A COVERED BENEFIT WITH MEDICAID MANAGED CARE FULLY EFFECTIVE February 1, 2018.
  • Hospital orders and pays for donor milk
  • Hospital submits form CMS 1450  (UB-04) for reimbursement
  • HCSPC code T2101 is for donor milk
  • Revenue Code 220 pulls donor milk out of the DRG
  • Submit for each baby who consumes donor milk either daily or weekly amount.
  • Use the actual acquisition fee.
  • Unit is 1 mL.

Please contact us for billing questions.

PLEASE CALL US AT 212.956.MILK (6455) IF YOUR HOSPITAL DOES NOT USE DONOR MILK OR IF YOU NEED HELP OBTAINING DONOR MILK FOR YOUR BABY.

DOH-2973 SAMPLE copy 2

DOH-2973I

*DOH-2973C_fillable copy 2

10 Steps to Using Donor Milk in the NICU copy