What is a Lactation Credit?
Faculty, trainees, and APPs returning from child-bearing leave are given the option of adding a “Lactation Hold” to their clinic schedule per half-day session. This lactation hold can be placed anywhere in a 4-hour session, and can be of any duration, template permitting. For eligible clinicians, regardless of the length of the hold, the hold will result in wRVUs credited to the clinician’s home department on a monthly basis for disbursement of funds or wRVU credit to the clinician. Each Lactation hold, regardless of the duration, will be reimbursed as a set amount of wRVUs --- equal to a 99214 (currently in 2025 1.92wRVUs.
How will providers know about this credit?
In preparation for their leave, expectant faculty and APPs should be informed of the option for Lactation credits by the Division/Department manager for physicians or Administrative supervisor for APPs, and introduced to the program. Providers can choose to work with their clinic to place holds either prior to or on return from leave. A repeat communication should be sent two weeks prior to return from maternity leave as a reminder to review clinic schedules. The new parent will be instructed to work with her clinic supervisor or designated scheduling admin to place these holds into her clinic schedule if desired. See sample letter below.
How will Lactation Credits be tracked?
The number of “Lactation holds” and corresponding wRVUs generated will be tracked by Faculty Practice Revenue Management Office and provided to the Departments on a monthly basis with the corresponding payment. This will be a similar mechanism to the tracking and payout of e-consults. Clinic staff can run a report of the number of lactation hold by provider, as outlined in the APeX Lactation Hold Tip Sheet. If holds are not placed or placed incorrectly, retroactive payments can be made only within the same fiscal year or until September 30th of the subsequent year. We cannot pay retroactive holds from a prior fiscal year beyond that date.
What are the responsibilities of the Division/Department Manager?
The responsibility of the Division/Department manager is to:
- Ensure all clinicians taking child-bearing leave are aware of this program prior to their leave and receive email communication regarding the program upon their return.
- Upon receipt of wRVU legers and payments, Division/Department Managers will need to properly allocate Lactation wRVU credits to the individual provider.
What are the responsibilities of the Practice Managers?
Practice Managers should inform those responsible for scheduling or managing provider templates about the new lactation hold visit type and the ability of those returning from childbearing leave to schedule one “Lactation Hold” visit per 4-hour session. Please see the Lactation Hold tip sheet for more details.
What happens if a clinician cancels their session?
If a clinic session is cancelled, the lactation hold visit should similarly be cancelled. A cancelled visit will not result in lactation credit being provided.
What should be done if a clinician decides to overbook her lactation hold visit?
If a clinician decides to overbook her visit, the lactation hold visit should be cancelled. A prompt in APeX will remind schedulers to remove the hold if an overlapping visit is booked.
Is this program available in all practice areas and at all sites?
Currently the lactation credit is available to clinicians practicing in all UCSF Health and SF Benioff Children’s Hospital sites who are on a UCSF Health wRVU based payment model. Oakland Benioff Children’s Clinics will follow shortly. Given our reliance on scheduling through EPIC to generate the credit, only clinics working in our instance of EPIC can participate at this time. In the future, we hope to expand to off license sites not on EPIC. Faculty in Departments or clinics who are paid on a UCSF health system staffing plan per FTE are not eligible for reimbursement in this program.
California law states that an employee has the right to pump for as long as needed. Why aren’t the lactation holds available beyond the first year after birth?
We completely understand that every breastfeeding (and weaning) journey looks different. Due to the financial constraints of the program, the reimbursed Lactation wRVU Credits are only offered up to 1 year after the birth of a child. However, in accordance with California law, clinicians are should be supported in continuing to block time in their clinical schedule for ongoing pumping needs. When blocking off time, however, they should not use the lactation hold credit which provides them automatic wRVU credit for that hold time.
What if I or my baby have special circumstances that make it important to pump beyond one year?
The program can accommodate clinicians who have specific needs to pump beyond one year. For an extension of lactation wRVU credits, please email Michelle.Mourad@ucsf.edu to request extended use of the program.
Additional Resources
With any additional questions about this program, please contact Michelle.Mourad@ucsf.edu
With any questions about the UCSF Lactation Accommodation Program, please contact lactationprogram@ucsf.edu or visit their website at https://tiny.UCSF.edu/UCSFpump
