Doula Services

Revised: September 16, 2025

· Overview

· Recommendation for Doula Services

· Eligible Providers

· Eligible Members

· Covered Services

· Noncovered Services

· Authorization Requirements

· Telehealth

· Billing

· Legal References

Overview

Minnesota Health Care Programs (MHCP) covers doula services. These services include emotional and physical support for pregnant people.

Recommendation for Doula Services

Medicaid and MinnesotaCare Medical Director Nathan Chomilo, MD, FAAP, FACP, issued a statewide standing recommendation for doula services. Now, an eligible MHCP member may seek out and receive care from an MHCP-enrolled doula services provider without getting their own individual referral or written recommendation from a physician. Refer to Recommendation for Doula Services for Pregnant and Postpartum Minnesota Health Care Programs Members (PDF) for the full recommendation.

Eligible Providers

Doulas who are registered with the Minnesota Department of Health (MDH) may enroll as doula providers for MHCP. Review Doula Enrollment Criteria and Forms for details.

MHCP-enrolled doula providers are allowed to provide or bill for doula services for an MHCP member because of the Recommendation for Doula Services for Pregnant and Postpartum Minnesota Health Care Programs Members (PDF) from Dr. Chomilo.

Eligible Members

All pregnant MHCP members are eligible to receive doula services from enrolled providers.

Covered Services

Covered services include informational, emotional, and physical support for pregnancy, labor and delivery, and postpartum birthing people. This also includes spiritually and culturally responsive care.

MHCP covers up to 18 sessions without prior authorization. These 18 sessions can be completed anytime during the prenatal, labor and delivery, and postpartum period. Refer to Authorization Requirements for information on adding additional sessions if the member requires more than 18.

MHCP covers doulas who attend labor and delivery in settings where a licensed birthing professional is attending the birth. These settings include hospitals, birth centers and within the home (home births).

MHCP covers attendance of a doula during a labor that results in an emergency Cesarean delivery.

Noncovered Services

Travel time and mileage are not covered services.

Documentation Requirements

Document each visit with a member in either written or electronic format. Document the following information from the visit:

· The member’s name

· The date of the visit

· Length of time spent with the member

· What was done, discussed and recommended in the visit with the member

· Any other important information from the visit. For example, if the member reports pain or high blood pressure, providers should note the concerns and recommendations they made on how to follow-up or to see a provider.

· The signature of the doula providing the service

Other standards apply (including that the documentation must be legible). Review the Health Service Records section under Provider Requirements in the MHCP Provider Manual for more information.

Authorization Requirements

To provide additional sessions (more than 18), the doula must request prior authorization following the guidelines in the Authorization section under Provider Basics in the MHCP Provider Manual. Providers must include documentation supporting the medical necessity of the additional sessions with the request.

Telehealth

A telehealth labor and delivery doula visit can be billed if the member’s needs were met by the doula during the labor and delivery process; and the doula was available to the member with no other commitments throughout the entirety of the labor and delivery process by telephone or video conference.

If the doula was unavailable during the entirety of the labor and delivery process but was able to provide key support during some of the labor and delivery, they may bill for a non-labor and delivery visit for their time spent with the member.

Providers must submit a completed and signed Telehealth Provider Assurance Statement (DHS-6806) (PDF) to the Minnesota Department of Human Services to bill for telehealth services. Review Telehealth Services in the MHCP Provider Manual for additional details.

Billing

Refer to the Billing Policy and Provider Requirements sections of the MHCP Provider Manual for an overview of MHCP billing policies and procedures.

· Bill using the 837P

· Enter the rendering doula’s provider identification number in the Rendering Provider box in MN−ITS

· Enter the provider identification number for the billing provider (this can be either the doula’s provider identification number if they are billing individually, or the billing provider’s provider identification number if they are the pay-to provider for the doula) in the Pay-To Provider box in MN−ITS

· Bill all non-labor and non-delivery sessions with T1033 (no modifier)

· Bill all labor and delivery sessions with T1033 with U4 modifier

· If the labor progresses over multiple days, bill for the date the doula was present providing services. Or, if the doula was present throughout the labor and delivery, bill the doula services for the date of the birth.

· If the labor results in an emergency Cesarean delivery, the doula may still bill the labor and delivery session with T1033 with U4 modifier.

Legal References

Minnesota Statutes, 144.651, subdivision 10, Health Care Bill of Rights: Participation in Planning Treatment; Notification of Family Members
Minnesota Statutes,148.995, subdivision 2, Definitions: Certified doula
Minnesota Statutes, 148.996, Registry
Minnesota Statutes, 256B.0625, subdivision 28b, Covered Services: Doula services
Minnesota 2014 Session Law, chapter 291, article 4, section 23 (amended section 148.995, subdivision 2)
Minnesota 2014 Session Law, chapter 291, article 4, section 24 (amended section 148.996, subdivision 2)

Code of Federal Regulations, title 42, chapter 4, subchapter c, part 440.130, c: Preventative Services