Pregnancy Resources

Member must be eligible for Iowa Total Care Medicaid at the time of the request.
Additional eligibility requirements:
- The breast pump must be deemed medically necessary.
- A prescription must be obtained from a physician (Doctor of Medicine, Osteopathy, or Podiatry) Physician Assistant or Advanced Registered Nurse Practitioner.
  - The prescription from the provider should include:
    - Member’s name.
    - Diagnosis.
    - Prognosis.
    - Item or items to be dispensed.
    - Length of time the item is to be required.
    - Signature of the prescriber and the signature date.
- The member should not have access to another payment source (i.e., private insurance).
- Breast pump must be purchased through a durable medical equipment (DME) supplier contracted with Iowa Total Care.
- Member will be allowed one breast pump per pregnancy.

The DME provider may bill Medicaid using code E0602 for a manual pump or E0603 for an electric pump (non-medical grade).
This code can only be billed under the mother (not baby).
Members do not have the ability to submit claims if they purchase the breast pump on their own.
Prior authorization is not required for a breast pump.
It is the DME supplier’s responsibility to collect insurance information and bill appropriately.

Providers and members can identify DME providers contracted with Iowa Total Care through their respective portals or online through specific vendor websites.
To find suppliers in each county:
- Visit our Find a Provider site.
- Enter ZIP code and plan (Iowa Total Care Medicaid).
- In Choose a Category section, select Pharmacy & Medical Supplies > Medical Equipment > Durable Medical Equipment & Medical Supplies.
- Additional filtering is available within search results.
Not all DME suppliers on the Find a Provider website carry breast pumps. You or the member should confirm with the supplier.
Call Provider Services for assistance or questions: 1-833-404-1061.

Notification of pregnancy forms (in both English and Spanish) are available on the Provider Manuals, Forms & Resources page.
Submit completed forms to Iowa Total Care via the secure provider portal or by fax: 1-833-257-8323.
These forms may also be completed by the member through the secure member portal.

Iowa Total Care's Start Smart for Your Baby program was created this program to provide advice and resources for pregnant members and new parents.

Member resources are just a click away. Visit our Start Smart for Your Baby page to learn more. Highlights include:

Breast Pump Ordering